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中华消化病与影像杂志(电子版) ›› 2022, Vol. 12 ›› Issue (04) : 215 -219. doi: 10.3877/cma.j.issn.2095-2015.2022.04.005

论著

代谢综合征对结直肠管状绒毛状腺瘤的影响因素分析
刘志威1, 赵利婷1, 余志荣2, 陈友鹏3,()   
  1. 1. 516211 广东惠州,南方医科大学附属惠阳医院感染性疾病科
    2. 516211 广东惠州,南方医科大学附属惠阳医院消化内科
    3. 518107 广东深圳,中山大学附属第七医院感染性疾病科
  • 收稿日期:2021-12-28 出版日期:2022-08-01
  • 通信作者: 陈友鹏

Relationship between metabolic syndrome and colorectal tubular villous adenoma

Zhiwei Liu1, Liting Zhao1, Zhirong Yu2, Youpeng Chen3,()   

  1. 1. Department of Infectious Diseases, Huiyang Hospital Affiliated to Southern Medical University, Huizhou 516211, China
    2. Department of Gastroenterology, Huiyang Hospital Affiliated to Southern Medical University, Huizhou 516211, China
    3. Department of Infectious Diseases, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
  • Received:2021-12-28 Published:2022-08-01
  • Corresponding author: Youpeng Chen
引用本文:

刘志威, 赵利婷, 余志荣, 陈友鹏. 代谢综合征对结直肠管状绒毛状腺瘤的影响因素分析[J/OL]. 中华消化病与影像杂志(电子版), 2022, 12(04): 215-219.

Zhiwei Liu, Liting Zhao, Zhirong Yu, Youpeng Chen. Relationship between metabolic syndrome and colorectal tubular villous adenoma[J/OL]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2022, 12(04): 215-219.

目的

分析结直肠管状绒毛状腺瘤与代谢综合征的关系。

方法

收集2017年6月至2020年12月南方医科大学附属惠阳医院经手术病理确诊的271例患者。其中管状腺瘤患者203例,管状绒毛状腺瘤患者68例。比较结直肠管状腺瘤与管状绒毛状腺瘤患者纤维结肠内镜检查的基本情况,结直肠息肉一般特征、数目、病理,以及代谢综合征相关指标水平等。采用Logistic多因素回归分析山田分型、最大息肉直径、代谢综合征相关指标与结直肠管状绒毛状腺瘤的关系。

结果

累计息肉数目最多部位、最大息肉好发部位、病理为管状绒毛状腺瘤/管状腺瘤好发部位均为乙状结肠。结直肠管状腺瘤与管状绒毛状腺瘤患者山田分型、最大息肉直径、血清甘油三酯水平差异均有统计学意义(P均<0.01),而高血压、脂肪肝、空腹血糖受损或糖尿病情况及总胆固醇水平、血清尿酸水平、癌胚抗原水平差异均无统计学意义(P>0.05)。Logistic多因素回归分析结果显示,山田分型及最大息肉直径与结直肠管状绒毛状腺瘤有关联[Wald χ2=5.756,Exp(B)=2.494,P=0.016;Wald χ2=23.173,Exp(B)=12.842,P<0.001],而血清甘油三酯水平与结直肠管状绒毛状腺瘤无关联。

结论

与结直肠管状腺瘤患者相比,代谢综合征与结直肠管状绒毛状腺瘤发病并无直接关联,但息肉直径大小及山田分型与结直肠管状绒毛状腺瘤发病有关联。

Objective

To analyze the relationship between colorectal tubular villous adenoma and metabolic syndrome

Methods

A total of 271 patients with surgical and pathological diagnosis in Huiyang Hospital Affiliated to Southern Medical University from June 2017 to December 2020 were collected. There were 203 cases of tubular adenoma and 68 cases of tubular villous adenoma. The basic information of fibercolonoscopy, general characteristics, number, pathology and metabolic syndrome related indexes of colorectal polyps were compared between tubular adenoma and tubular villous adenoma patients. Logistic regression analysis was used to analyze the relationship between Yamada classification, maximum polyp diameter, metabolic syndrome related indexes and colorectal tubular villous adenoma.

Results

The site with the largest cumulative number of polyps, the most prone site of polyps, and the common sites of tubular villous adenoma and tubular adenoma were sigmoid colon. The differences between the patients with colorectal tubular adenoma and tubular villous adenoma were statistically significant in Yamada classification, maximum polyp diameter, serum triglyceride (all P<0.01), but there were no statistically significant differences in hypertension, fatty liver, impaired fasting glucose or diabetes, total cholesterol, serum uric acid level and carcinoembryonic antigen level. Logistic regression analysis showed that Yamada classification [Wald χ2=5.756, Exp(B)=2.494, P=0.016] and maximum polyp diameter [Wald χ2=23.173, Exp(B)=12.842, P<0.001] were correlated with colorectal tubular villous adenoma, but serum triglyceride level was not correlated with colorectal tubular villous adenoma.

Conclusion

Compared with patients with tubular adenoma, metabolic syndrome is not directly related to the pathogenesis of colorectal tubular villous adenoma, but polyp diameter and Yamada classification are closely related to the pathogenesis of colorectal tubular villous adenoma.

图1 管状绒毛状腺瘤病理表现。图A为HE染色,×100;图B为HE染色,×150
图2 管状腺瘤病理表现。图A为HE染色,×200;图B为HE染色,×100
表1 管状绒毛状腺瘤组与管状腺瘤组患者一般临床资料比较
表2 Logistic回归分析结果
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