Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA.
Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
BMC Gastroenterol. 2020 Jun 5;20(1):170. doi: 10.1186/s12876-020-01279-y.
Colitis is generally considered a risk factor for colon neoplasia. However, not all types of colitis seem to have equal neoplastic transformation potential.
To determine the prevalence of colorectal polyps in a predominantly African American population with inflammatory bowel disease (IBD) and Non-IBD/Non-Infectious Colitis (NIC).
We retrospectively evaluated medical records of 1060 patients previously identified with colitis at Howard University Hospital, based on ICD-10 code. Among these, 485 patients were included in the study: 70 IBD and 415 NIC based on a thorough review of colonoscopy, pathology and clinical reports. Logistic regression analysis was applied to estimate the risk of polyps in patients with IBD compared to those with NIC after adjusting for age and sex. A subgroup analysis within the IBD group was performed.
Of the 485 patients, 415 were NIC and 70 were IBD. Seventy-three percent of the NIC patients and 81% of the IBD patients were African Americans. Forty six percent of IBD and 41% of NIC cases were male. IBD patients were younger than NIC patients (median age of 38 years vs. 50, P < 0.001). The prevalence of all types of polyps was 15.7 and 8.2% in the IBD and NIC groups, respectively (P = 0.045). Among patients with polyps, the prevalence of inflammatory polyps was higher in the IBD group (55%) compared to the NIC group (12%). After adjusting for age, sex and race, odds ratio of inflammatory polyps in IBD patients was 6.0 (P = 0.016). Adenoma prevalence was 4.3% (3/70) in IBD patients and 3.9% (16/415) in the NIC patients (p = 0.75). The anatomic distribution of lesions and colitis shows that polyps occur predominantly in the colitis field regardless of colitis type. More polyps were present in the ulcerative colitis patients when compared to Crohn's disease patients (27% vs. 5%, P < 0.001) within the IBD group.
Our study shows that inflammatory polyps are more common in IBD patients when compared to NIC patients. Most polyps were in the same location as the colitis.
结肠炎通常被认为是结肠癌的一个危险因素。然而，并非所有类型的结肠炎似乎都具有同等的肿瘤转化潜能。
确定以非裔美国人为主的炎症性肠病（IBD）和非 IBD/非感染性结肠炎（NIC）患者中结直肠息肉的患病率。
我们回顾性评估了霍华德大学医院根据 ICD-10 代码确定的 1060 例先前患有结肠炎的患者的病历。其中，485 例患者纳入研究：70 例 IBD 和 415 例 NIC，这是基于结肠镜检查、病理和临床报告的彻底审查。应用逻辑回归分析估计 IBD 患者与 NIC 患者相比发生息肉的风险，调整年龄和性别后进行分析。在 IBD 组内进行了亚组分析。
在 485 例患者中，415 例为 NIC，70 例为 IBD。73%的 NIC 患者和 81%的 IBD 患者为非裔美国人。46%的 IBD 和 41%的 NIC 病例为男性。IBD 患者比 NIC 患者年轻（中位年龄 38 岁比 50 岁，P<0.001）。IBD 组和 NIC 组的所有类型息肉的患病率分别为 15.7%和 8.2%（P=0.045）。在有息肉的患者中，IBD 组的炎症性息肉患病率（55%）高于 NIC 组（12%）。调整年龄、性别和种族后，IBD 患者炎症性息肉的比值比为 6.0（P=0.016）。IBD 患者的腺瘤患病率为 4.3%（3/70），NIC 患者为 3.9%（16/415）（p=0.75）。病变和结肠炎的解剖分布表明，无论结肠炎类型如何，息肉主要发生在结肠炎部位。与克罗恩病患者相比，溃疡性结肠炎患者的息肉更多（27%比 5%，P<0.001）。
我们的研究表明，与 NIC 患者相比，IBD 患者的炎症性息肉更为常见。大多数息肉位于与结肠炎相同的部位。
