50岁及以上结直肠腺瘤高、低级别上皮内瘤变的影响因素分析

Factors influencing grades of intraepithelial neoplasia of colorectal adenoma in patients over 50 years old

目的分析50岁及以上结直肠腺瘤高、低级别上皮内瘤变的影响因素。方法纳入2017年5月至2018年8月于北京市二龙路医院行电子结肠镜检查诊断为结直肠腺瘤的325例50岁及以上患者为研究对象,以免疫组化结果提示高、低级别上皮内瘤变为依据,分为高级别上皮内瘤变组(n=158)和低级别上皮内瘤变组(n=167),比较不同性别、病变位置、充血情况及病理分型的结直肠腺瘤高、低级别上皮内瘤变发病比例,探讨结直肠腺瘤高、低级别上皮内瘤变的影响因素。结果单因素分析结果显示,性别与结直肠腺瘤高、低级别上皮内瘤变无关,差异无统计学意义(P> 0.05);不同病变位置、腺瘤充血情况、腺瘤病理类型的结直肠腺瘤高、低级别上皮内瘤变发病比例不同,在高级别上皮内瘤变组中,病变位置在直肠比例高于低级别上皮内瘤变组,差异均有统计学意义(均P <0.05);多因素分析结果显示病变位置、腺瘤充血情况、腺瘤病理类型是结直肠腺瘤不同级别上皮内瘤变的独立影响因素(均P <0.05)。结论腺瘤病变位置、充血情况、病理类型与不同级别结直肠腺瘤上皮内瘤变相关。

Objectives To investigate factors influencing grades of intraepithelial neoplasia of colorectal adenoma in patientsover 50 years old. Methods A total of 325 patients over 50 years old diagnosed with colorectal adenoma by electronic colonos-copy at Beijing Er Long Lu Hospital between May 2017 and August 2018 were recruited. Patients were divided into high-gradeintraepithelial neoplasia group(n = 158) and low-grade intraepithelial neoplasia group(n = 167) according to immunohistonchemis-try report on intraepithelial neoplasia. Grades of intraepithelial neoplasia were compared between sex, location of lesions, hyper-emia and pathological classification. Multivariate analysis was performed to investigate independent factors influencing grades of in-traepithelial neoplasia. Results Univariate analysis showed that sex is not associated with grades of intraepithelial neoplasia(P > 0.05). There was significant difference in grades of intraepithelial neoplasia among the different location of lesions, levels ofhyperemia and pathological classification(P < 0.05). The incidence site in the rectum was higher in high-grade intraepithelialneoplasia group than in low-grade intraepithelial neoplasia group(P < 0.05). Multivariate analysis showed that location of le-sions, hyperemia, and pathological classification were independent factors influencing grades of intraepithelial neoplasia(P <0.05). Conclusion Location of lesions, hyperemia and pathological classification were associated with grades of intraepithelial neo-plasia.