Pothoulakis Ioannis, Wikholm Colin, Verma Vipin, Ahmad Akram I, Vangimalla Shiva S, Patel Harshkumar, Oh Jae H, Zhao Alex, Gress Kyle L, Bovill John, Deshpande Nikita, Marquez Maria, Dean Brynley, Gholson Dwight A, Bhogal Loveleen, Buchanan Faith, Cho Won Kyoo
Department of Medicine MedStar Washington Hospital Center Washington District of Columbia USA.
Georgetown University School of Medicine Washington District of Columbia USA.
JGH Open. 2022 Feb 4;6(3):159-165. doi: 10.1002/jgh3.12708. eCollection 2022 Mar.
Colonic wall thickening (CWT) is commonly associated with clinically significant pathologies, but predictive factors of such pathologies are not well known. This study aims to identify the predictors of clinically significant pathologies, such as colorectal carcinoma (CRC) and inflammatory bowel disease (IBD), in patients with CWT.
Subjects with an abnormal abdominal computed tomography (CT) and a follow-up colonoscopy between 2010 and 2020 were retrospectively reviewed. Patients with CWT in the CT were included and examined in this study. A multivariable logistic regression analysis was performed to assess for factors independently associated with CRC or IBD in these subjects. Receiver operating characteristic (ROC) curve analysis was used to further examine significant parameters in multivariable logistic regression analysis.
Among 403 patients with CWT on CT scans who underwent a colonoscopy, 269 subjects who met the inclusion criteria were identified and studied. On multivariable logistic regression models, elevated platelet count, low hematocrit, and localized CWT were found to be independently associated with CRC, while elevated platelet count and younger age were independently associated with IBD. On ROC curve analysis for CRC, area under the curve (AUC) for hematocrit, platelets, and localized CWT was 0.76, 0.75, and 0.61, respectively. On ROC curve analysis for IBD, AUC for age and platelets was 0.90 and 0.69, respectively.
Elevated platelet count, low hematocrit, and localized CWT can be potentially used as predictors of CRC in patients with CWT. Elevated platelet count and young age can be used to predict IBD in these patients.
结肠壁增厚（CWT）通常与具有临床意义的病变相关，但此类病变的预测因素尚不明确。本研究旨在确定CWT患者中具有临床意义的病变（如结直肠癌（CRC）和炎症性肠病（IBD））的预测因素。
回顾性分析2010年至2020年间腹部计算机断层扫描（CT）异常且接受了后续结肠镜检查的受试者。本研究纳入并检查了CT检查发现有CWT的患者。进行多变量逻辑回归分析，以评估这些受试者中与CRC或IBD独立相关的因素。采用受试者工作特征（ROC）曲线分析进一步检验多变量逻辑回归分析中的显著参数。
在403例CT扫描显示有CWT且接受了结肠镜检查的患者中，确定并研究了269例符合纳入标准的受试者。在多变量逻辑回归模型中，血小板计数升高、血细胞比容降低和局限性CWT与CRC独立相关，而血小板计数升高和年龄较小与IBD独立相关。在针对CRC的ROC曲线分析中，血细胞比容、血小板和局限性CWT的曲线下面积（AUC）分别为0.76、0.75和0.61。在针对IBD的ROC曲线分析中，年龄和血小板的AUC分别为0.90和0.69。
血小板计数升高、血细胞比容降低和局限性CWT可潜在地用作CWT患者CRC的预测指标。血小板计数升高和年龄较小可用于预测这些患者的IBD。
