代谢综合征组分与结直肠腺瘤临床病理特征的相关性

Relationship Between Components of Metabolic Syndrome and Clinicopathological Characteristics of Colorectal Adenoma

背景:结直肠癌(CRC)是消化系统常见的恶性肿瘤之一,结直肠腺瘤(CRA)为公认的CRC癌前病变。因此,寻找CRA的危险因素对预防CRC具有重要意义。目的:探讨代谢综合征(MS)组分与CRA临床病理特征的相关性。方法:收集2014年12月—2016年12月内蒙古医科大学附属医院收治的460例CRA患者,记录MS组分和CRA的临床病理特征。MS与CRA临床病理特征相关性的分析采用χ2检验或Spearman秩相关分析。CRA临床病理特征的影响因素分析采用Logistic回归分析。结果:MS与CRA病理类型、CRA带蒂、CRA大小相关(P<0.001,rp=0.317;P<0.001,rp=0.321;P=0.001,rs=0.150),而与CRA部位、数目无关(P>0.05)。高血压、糖尿病、高三酰甘油(TG)、高腰围可使绒毛状腺瘤发生风险增加(P<0.05),年龄、高腰围可使管状绒毛状腺瘤发生风险增加(P<0.05)。高血压、高TG、高腰围可使CRA带蒂的发生风险增加(P<0.05)。年龄可使全结肠CRA发生风险增加(P<0.05),其余因素对近端结肠CRA、全结肠CRA均无明显影响(P>0.05)。糖尿病、高腰围为影响CRA大小的危险因素(P<0.05)。性别、年龄、高血压、糖尿病、高TG、低HDL、高腰围与CRA数目均无关(P>0.05)。结论:MS与CRA的病理类型、是否带蒂、大小相关。高血压、糖尿病、高TG、高腰围为绒毛状腺瘤的危险因素;年龄、高腰围为管状绒毛状腺瘤的危险因素。高血压、高TG、高腰围为CRA带蒂的危险因素。年龄为全结肠CRA的危险因素。糖尿病、高腰围为CRA大小的危险因素。

Background: Colorectal cancer (CRC) is one of the most common malignant tumors in digestive system. Colorectal adenoma (CRA) is recognized as a precancerous lesion of CRC. Therefore, it is of great significance to find the risk factors of CRA for the prevention of CRC. Aims: To investigate the relationship between components of metabolic syndrome (MS) and clinicopathological characteristics of CRA. Methods: A total of 460 patients with CRA from December 2014 to December 2016 at the Affiliated Hospital of Inner Mongolia Medical University were enrolled. Components of MS and clinicopathological characteristics were recorded. Correlation of MS with clinicopathological characteristics of CRA were analyzed by χ 2 test or Spearman’s rank correlation. Influencing factors of clinicopathological characteristics of CRA were analyzed by multivariate Logistic regression analysis. Results: MS was related to pathological type, pedicle, and size of CRA ( P < 0.001 , r p =0.317;P <0.001, r p =0.321;P =0.001, r s =0.150), but not related to location and number of CRA ( P >0.05). Hypertension, diabetes, high triglyceride (TG), high waistline increased the risk of villous adenoma ( P <0.05), while age, high waistline increased the risk of tubulovillous adenoma ( P <0.05). Hypertension, high TG, high waistline increased the risk of CRA pedicle ( P <0.05). Age increased the risk of CRA in the whole colon ( P < 0.05), however, gender, hypertension, diabetes, high TG, low HDL, high waistline had no significant influence on CRA in proximal colon and whole colon ( P >0.05). Diabetes, high waistline were the risk factors of size of CRA ( P <0.05). Gender, age, hypertension, diabetes, high TG, low HDL, high waistline were not related to the number of CRA ( P > 0.05). Conclusions: MS is correlated with pathological type, pedicle, and size of CRA. Hypertension, diabetes, high TG, high waistline are the risk factors of villous adenoma;while age, high waistline are the risk factors of tubulovillous adenoma. Hypertension, high TG, high waistline are the risk factors for CRA with pedicle. Age is the risk factor for CRA in the whole colon. Diabetes, high waistline are the risk factors for size of CRA.