目的探讨小儿肠息肉发生的危险因素,并建立列线图(Nomogram)模型对儿童患肠息肉(intestinal polyps,IP)的风险进行预测。方法选取2018年1月至2020年7月在徐州市儿童医院行肠镜检查的248例患儿(14岁以下)为研究对象,按结果有无IP分为IP组...目的探讨小儿肠息肉发生的危险因素,并建立列线图(Nomogram)模型对儿童患肠息肉(intestinal polyps,IP)的风险进行预测。方法选取2018年1月至2020年7月在徐州市儿童医院行肠镜检查的248例患儿(14岁以下)为研究对象,按结果有无IP分为IP组(112例)和无IP组(136例),并采用Logistic回归分析筛选其独立危险因素。然后纳入筛选出的独立危险因素建立Nomogram预测模型,并验证该模型的预测性及准确度。结果通过对两组患儿一般临床资料做Logistic回归分析可知,年龄(OR=7.299,95%CI:2.020~26.316)、性别(OR=8.264,95%CI:3.717~18.519)、体质指数(body mass index,BMI)(OR=2.457,95%CI:1.160~5.181)、癌症家族遗传史(OR=18.182,95%CI:3.497~45.637)、食用红肉(OR=4.202,95%CI:1.957~9.009)及食用腌制食品(OR=4.255,95%CI:1.842~9.804)为儿童患肠息肉的独立危险因素,食用水果蔬菜(OR=0.353,95%CI:0.184~0.676)为肠息肉的保护性因素,具有统计学差异(P<0.05)。根据筛选的独立危险因素,建立了Nomogram模型,经验证,该模型预测值与实测值基本一致,预测能力较好,同时用Bootstrap内部验证法验证该模型,C-index指数高达0.859(95%CI:0.854~0.864),表明该模型精准度、区分度良好。结论年龄、男性、BMI≥24kg/m^(2)、癌症家族遗传史、食用红肉、食用腌制食品是小儿肠息肉的独立危险因素,食用水果蔬菜是小儿肠息肉的保护性因素。展开更多
Traditional serrated adenoma(TSA)is a type of serrated polyp of the colorectum and is thought to be a precancerous lesion.There are three types of serrated polyps,namely,hyperplastic polyps,sessile serrated adenomas/p...Traditional serrated adenoma(TSA)is a type of serrated polyp of the colorectum and is thought to be a precancerous lesion.There are three types of serrated polyps,namely,hyperplastic polyps,sessile serrated adenomas/polyps,and TSAs.TSA is the least common of the three types and accounts for about 5% of serrated polyps.Here we report a pediatric case of TSA that was successfully resected by endoscopic submucosal dissection(ESD).This rare case report describes a pediatric patient with no family history of colonic polyp who was admitted to our hospital with hematochezia.On colonoscopy,we found a polypoid lesion measuring 10 mm in diameter in the lower rectum.We selected ESD as a surgical option for en bloc resection,and histopathological examination revealed TSA.The findings in this case suggest that TSA with precancerous potential can occur in children,and that ESD is useful for treating this lesion.展开更多
文摘目的探讨小儿肠息肉发生的危险因素,并建立列线图(Nomogram)模型对儿童患肠息肉(intestinal polyps,IP)的风险进行预测。方法选取2018年1月至2020年7月在徐州市儿童医院行肠镜检查的248例患儿(14岁以下)为研究对象,按结果有无IP分为IP组(112例)和无IP组(136例),并采用Logistic回归分析筛选其独立危险因素。然后纳入筛选出的独立危险因素建立Nomogram预测模型,并验证该模型的预测性及准确度。结果通过对两组患儿一般临床资料做Logistic回归分析可知,年龄(OR=7.299,95%CI:2.020~26.316)、性别(OR=8.264,95%CI:3.717~18.519)、体质指数(body mass index,BMI)(OR=2.457,95%CI:1.160~5.181)、癌症家族遗传史(OR=18.182,95%CI:3.497~45.637)、食用红肉(OR=4.202,95%CI:1.957~9.009)及食用腌制食品(OR=4.255,95%CI:1.842~9.804)为儿童患肠息肉的独立危险因素,食用水果蔬菜(OR=0.353,95%CI:0.184~0.676)为肠息肉的保护性因素,具有统计学差异(P<0.05)。根据筛选的独立危险因素,建立了Nomogram模型,经验证,该模型预测值与实测值基本一致,预测能力较好,同时用Bootstrap内部验证法验证该模型,C-index指数高达0.859(95%CI:0.854~0.864),表明该模型精准度、区分度良好。结论年龄、男性、BMI≥24kg/m^(2)、癌症家族遗传史、食用红肉、食用腌制食品是小儿肠息肉的独立危险因素,食用水果蔬菜是小儿肠息肉的保护性因素。
文摘Traditional serrated adenoma(TSA)is a type of serrated polyp of the colorectum and is thought to be a precancerous lesion.There are three types of serrated polyps,namely,hyperplastic polyps,sessile serrated adenomas/polyps,and TSAs.TSA is the least common of the three types and accounts for about 5% of serrated polyps.Here we report a pediatric case of TSA that was successfully resected by endoscopic submucosal dissection(ESD).This rare case report describes a pediatric patient with no family history of colonic polyp who was admitted to our hospital with hematochezia.On colonoscopy,we found a polypoid lesion measuring 10 mm in diameter in the lower rectum.We selected ESD as a surgical option for en bloc resection,and histopathological examination revealed TSA.The findings in this case suggest that TSA with precancerous potential can occur in children,and that ESD is useful for treating this lesion.
