Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, NO. 109 Xueyuan Road, Wenzhou, 325000, Zhejiang Province, China.
BMC Pediatr. 2023 Aug 19;23(1):408. doi: 10.1186/s12887-023-04197-6.
Scarce evidence exists on pediatric colorectal polyp risk factors. This study explored the clinical manifestations, morphological and pathological characteristics of, and risk factors for pediatric colorectal polyps.
This retrospective case-control study included children who received colonoscopy, divided into a colorectal polyp group and a normal control group based on colonoscopy results. The risk factors for colorectal polyps in children were analyzed through logistic regression analysis.
The mean age of children with polyps was 6.77 ± 3.44 years. Polyps were detected predominantly in males (72.9%); hematochezia was the primary clinical manifestation (80.25%). Most polyps were juvenile (88.9%) and solitary (87.7%); 50.6% were located in the rectosigmoid area. Univariate analysis showed that gender (P = 0.037), age (P < 0.001), family aggregation (P < 0.001), specific immunoglobulin E (sIgE) (P < 0.001), platelet count (P = 0.001), aspartate aminotransferase (AST) (P = 0.016), meat intake (P = 0.010), and vegetable intake (P < 0.001) were significantly associated with colorectal polyps. Age ≤ 6 years (3-6 years: OR: 26.601, 95% CI: 3.761-160.910; < 3 years: OR: 22.678, 95% CI: 1.873-274.535), positive family aggregation (OR: 3.540, 95% CI: 1.177-10.643), positive sIgE (OR:2.263, 95% CI: 1.076-4.761), and higher meat intake (OR:1.046, 95% CI: 1.029-1.063) were risk factors for pediatric colorectal polyps in logistic regression analysis. Higher vegetable intake (OR: 0.993, 95% CI: 0.986-1.000) was a protective factor against pediatric colorectal polyps. The area under the curve (AUC) of meat intake in the receiver operating characteristic (ROC) curve analysis for predicting colorectal polyps was 0.607; the best cut-off value was 92.14 g/d (P = 0.010, 95% CI: 0.527-0.687). The meat and vegetable intake combination AUC in predicting pediatric colorectal polyps was 0.781 (P < 0.001, 95% CI: 0.718-0.845).
Juvenile, solitary, and located in the rectosigmoid region polyps are most common in children. Hematochezia is the main clinical manifestation. Most polyps were, but multiple and proximally located polyps were also detected. Age ≤ 6 years, especially 3-6 years, positive family aggregation, positive sIgE, and higher meat intake are risk factors for pediatric colorectal polyps. A higher vegetable intake is a protective factor.
小儿结肠直肠息肉的风险因素证据有限。本研究探讨了小儿结肠直肠息肉的临床表现、形态学和病理学特征以及风险因素。
本回顾性病例对照研究纳入了接受结肠镜检查的儿童，根据结肠镜检查结果分为结肠直肠息肉组和正常对照组。通过逻辑回归分析分析儿童结肠息肉的危险因素。
息肉患儿的平均年龄为 6.77±3.44 岁。息肉主要发生在男性（72.9%）；主要临床表现为血便（80.25%）。大多数息肉为青少年（88.9%）和单发（87.7%）；50.6%位于直肠乙状结肠区域。单因素分析显示，性别（P=0.037）、年龄（P<0.001）、家族聚集（P<0.001）、特异性免疫球蛋白 E（sIgE）（P<0.001）、血小板计数（P=0.001）、天冬氨酸转氨酶（AST）（P=0.016）、肉类摄入量（P=0.010）和蔬菜摄入量（P<0.001）与结肠直肠息肉显著相关。年龄≤6 岁（3-6 岁：OR：26.601，95%CI：3.761-160.910；<3 岁：OR：22.678，95%CI：1.873-274.535）、阳性家族聚集（OR：3.540，95%CI：1.177-10.643）、阳性 sIgE（OR：2.263，95%CI：1.076-4.761）和较高的肉类摄入量（OR：1.046，95%CI：1.029-1.063）是小儿结肠直肠息肉的危险因素。较高的蔬菜摄入量（OR：0.993，95%CI：0.986-1.000）是小儿结肠直肠息肉的保护因素。ROC 曲线分析中肉类摄入量的曲线下面积（AUC）预测结肠直肠息肉为 0.607；最佳截断值为 92.14 g/d（P=0.010，95%CI：0.527-0.687）。预测小儿结肠直肠息肉的肉菜摄入组合 AUC 为 0.781（P<0.001，95%CI：0.718-0.845）。
儿童中最常见的息肉是青少年、单发、位于直肠乙状结肠区域。血便是主要的临床表现。大多数息肉为单发，但也有多发和近端息肉。年龄≤6 岁，尤其是 3-6 岁、阳性家族聚集、阳性 sIgE 和较高的肉类摄入量是小儿结肠直肠息肉的危险因素。较高的蔬菜摄入量是一种保护因素。
