Park Yoo Mi, Kim Hee Sun, Park Jae Jun, Baik Su Jung, Youn Young Hoon, Kim Jie-Hyun, Park Hyojin
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, South Korea.
Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
BMC Gastroenterol. 2017 Jan 9;17(1):7. doi: 10.1186/s12876-016-0562-9.
Limited data are available for advanced colorectal neoplasm in asymptomatic individuals aged 40-49 years. We aimed to identify risk factors and develop a simple prediction model for advanced colorectal neoplasm in these persons.
Clinical data were collected on 2781 asymptomatic subjects aged 40-49 years who underwent colonoscopy for routine health examination. Subjects were randomly allocated to a development or validation set. Logistic regression analysis was used to determine predictors of advanced colorectal neoplasm.
The prevalence of overall and advanced colorectal neoplasm was 20.2 and 2.5% respectively. Older age (45-49 years), male sex, positive serology of Helicobacter pylori, and high triglyceride and low high-density lipoprotein (HDL) levels were independently associated with an increased risk of advanced colorectal neoplasm. BMI (body mass index) was not significant in multivariable analysis. We developed a simple scoring model for advanced colorectal neoplasm (range 0-9). A cutoff of ≥4 defined 43% of subjects as high risk for advanced colorectal neoplasm (sensitivity, 79%; specificity, 58%; area under the receiver operating curve = 0.72) in the validation datasets.
Older age (45-49 years), male sex, positive serology of H. pylori, high triglyceride level, and low HDL level were identified as independent risk factors for advanced colorectal neoplasm.
关于40 - 49岁无症状个体的晚期结直肠肿瘤的数据有限。我们旨在确定这些人群中晚期结直肠肿瘤的危险因素并开发一个简单的预测模型。
收集了2781名40 - 49岁因常规健康检查接受结肠镜检查的无症状受试者的临床数据。受试者被随机分配到开发集或验证集。采用逻辑回归分析来确定晚期结直肠肿瘤的预测因素。
总体和晚期结直肠肿瘤的患病率分别为20.2%和2.5%。年龄较大（45 - 49岁）、男性、幽门螺杆菌血清学阳性、高甘油三酯和低高密度脂蛋白（HDL）水平与晚期结直肠肿瘤风险增加独立相关。在多变量分析中，体重指数（BMI）不显著。我们开发了一个用于晚期结直肠肿瘤的简单评分模型（范围0 - 9）。在验证数据集中，≥4的截断值将43%的受试者定义为晚期结直肠肿瘤的高风险人群（敏感性为79%；特异性为58%；受试者操作特征曲线下面积 = 0.72）。
年龄较大（45 - 49岁）、男性、幽门螺杆菌血清学阳性、高甘油三酯水平和低HDL水平被确定为晚期结直肠肿瘤的独立危险因素。
