结肠息肉不典型增生的单因素及多因素分析

PATIENT AND POLYP CHARACTERISTICS ASSOCIATED WITH GRADS OF DYSPLASIA IN COLORECTAL ADENOMAS

目的 :回顾统计分析有病理诊断的结肠息肉 ,更好地认识结肠息肉的临床特点 ,找出与不典型增生息肉相关的因素。方法 :回顾分析镜下切除或钳除的结肠息肉病例共 560例 ,息肉 62 4枚。因变量包括性别、年龄、息肉部位、数目、形态、黏膜情况、是否分叶、病理类型、息肉大小等因素。统计方法包括卡方检验 ,多样本秩和检验 ,spearman等级相关检验 ,逐步logistic分析。结果 :单因素分析显示与不典型增生息肉相关的因素有年龄、息肉大小、黏膜情况、是否分叶状、病理类型。对所有因变量多因素进行逐步logistic分析显示 ,能够独立影响应变量的因变量有年龄、黏膜情况和病理类型。当因变量不包括息肉形态 ,黏膜情况及是否分叶时 ,能够独立影响应变量的因变量有年龄、病理类型和息肉大小。结论 :黏膜有糜烂甚至溃疡、年龄越大、息肉分叶 ,则息肉发生不典型增生的可能性越大。病理为炎性、幼年性、增生性或错构性息肉 ,则息肉发生不典型增生的可能性小。当因变量不包括息肉形态 ,黏膜情况及是否分叶时 ,息肉越大发生不典型增生的可能性越大。

Objective:To retrospectively analyse the patient and polyp factors related to the risk of grads of dysplasia in various colorectal polyps.Methods:Data on a total of 560 patients (624 polyps) who had undergone polypectomy between 1997 and 2000 at PLA General Hospital was collected. The relation between grads of dysplasia and patient and polyp characteristics was assessed by Logistic Regression, Chi-square, Kruskal-Wallis, Spearman Correlation.Results:The risk of grads of dysplasia was significantly related with the size of polyps (OR=4.204, P =0.001),histology of polyps(OR=0.658, P =0.014), age (OR=1.843, P =0.001).Conclusions:Large in size, age of patients, histology of polyps were confirmed as the major predictors. The more factors the polyp posseses, the more likely it will has dysplasia.