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老年与非老年人群锯齿状息肉伴同时性高级别腺瘤的临床特征及危险因素分析:一项回顾性队列研究。

Analysis of clinical characteristics and risk factors on serrated polyps with synchronous advanced adenoma in elderly and non-elderly people: a retrospective cohort study.

机构信息

Department of Gastroenterology, Xuanwu Hospital Capital Medical University, Beijing, China.

Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, China.

出版信息

BMJ Open. 2024 Nov 14;14(11):e083930. doi: 10.1136/bmjopen-2024-083930.

Abstract

OBJECTIVES

Serrated polyps (SPs) with synchronous advanced adenoma (AA) may increase the incidence of colorectal cancer. However, current studies do not address this combination of SPs and AAs in detail with regard to their clinical characteristics in different age groups. The aim was to assess clinical characteristics and risk factors for SPs with synchronous AA in different age groups.

DESIGN

Retrospective cohort study.

SETTING

Electronic medical record data from January 2011 to January 2022 at three grade III class A hospitals were enrolled in the study.

PARTICIPANTS

A total of 1605 patients with SPs with synchronous AA, including 484 patients in the elderly group and 1121 patients in the non-elderly group, were studied.

MAIN EXPOSURE MEASURE

The elderly group and the non-elderly group.

MAIN OUTCOME MEASURE

Sex, smoking history, drinking history, body mass index (BMI), SP location, size, morphology and pathology.

RESULTS

The incidence of hyperplastic polyps (HPs) with synchronous AA in the elderly group was higher than that in the non-elderly group, while the incidence of sessile serrated adenomas/polyps (SSAs/Ps) with synchronous AA in the non-elderly group was higher than that in the elderly group. Male sex, drinking history and HP size (≤20 mm) were independent risk factors for HPs with synchronous AA in the non-elderly group, while drinking history and HP size (≤15 mm) were independent risk factors in the elderly group. For SSAs/Ps with synchronous AA, male sex, smoking history, drinking history, and SSA size (≥16 mm) were independent risk factors in the non-elderly group; high BMI was an independent risk factor in the elderly group.

CONCLUSIONS

SPs with synchronous AA showed different clinical characteristics and risk factors in different age groups.

摘要

目的

锯齿状息肉(SPs)伴同时性高级别腺瘤(AA)可能会增加结直肠癌的发病率。然而,目前的研究并没有详细探讨不同年龄段SPs 伴同时性 AAs 的这种组合,以及它们的临床特征。本研究旨在评估不同年龄段伴有同时性 AA 的 SPs 的临床特征和危险因素。

设计

回顾性队列研究。

设置

本研究纳入了 2011 年 1 月至 2022 年 1 月三家三级甲等医院的电子病历数据。

参与者

共纳入 1605 例 SPs 伴同时性 AA 患者,其中老年组 484 例,非老年组 1121 例。

主要暴露测量指标

老年组和非老年组。

主要结局测量指标

性别、吸烟史、饮酒史、体重指数(BMI)、SP 位置、大小、形态和病理。

结果

老年组 HPs 伴同时性 AA 的发生率高于非老年组,而非老年组 SSA/Ps 伴同时性 AA 的发生率高于老年组。非老年组中男性、饮酒史和 HP 大小(≤20mm)是 HPs 伴同时性 AA 的独立危险因素,而老年组中饮酒史和 HP 大小(≤15mm)是独立危险因素。对于 SSA/Ps 伴同时性 AA,非老年组中男性、吸烟史、饮酒史和 SSA 大小(≥16mm)是独立危险因素;而在老年组中,高 BMI 是独立危险因素。

结论

不同年龄段 SPs 伴同时性 AA 表现出不同的临床特征和危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8ec/11580302/d308e14b90a4/bmjopen-14-11-g001.jpg

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