代谢综合征对结直肠管状绒毛状腺瘤的影响因素分析

目的分析结直肠管状绒毛状腺瘤与代谢综合征的关系。 方法收集2017年6月至2020年12月南方医科大学附属惠阳医院经手术病理确诊的271例患者。其中管状腺瘤患者203例，管状绒毛状腺瘤患者68例。比较结直肠管状腺瘤与管状绒毛状腺瘤患者纤维结肠内镜检查的基本情况，结直肠息肉一般特征、数目、病理，以及代谢综合征相关指标水平等。采用Logistic多因素回归分析山田分型、最大息肉直径、代谢综合征相关指标与结直肠管状绒毛状腺瘤的关系。 结果累计息肉数目最多部位、最大息肉好发部位、病理为管状绒毛状腺瘤/管状腺瘤好发部位均为乙状结肠。结直肠管状腺瘤与管状绒毛状腺瘤患者山田分型、最大息肉直径、血清甘油三酯水平差异均有统计学意义（P均<0.01），而高血压、脂肪肝、空腹血糖受损或糖尿病情况及总胆固醇水平、血清尿酸水平、癌胚抗原水平差异均无统计学意义（P>0.05）。Logistic多因素回归分析结果显示，山田分型及最大息肉直径与结直肠管状绒毛状腺瘤有关联Wald χ²=5.756，Exp（B）=2.494，P=0.016；Wald χ²=23.173，Exp（B）=12.842，P<0.001]，而血清甘油三酯水平与结直肠管状绒毛状腺瘤无关联。 结论与结直肠管状腺瘤患者相比，代谢综合征与结直肠管状绒毛状腺瘤发病并无直接关联，但息肉直径大小及山田分型与结直肠管状绒毛状腺瘤发病有关联。

Relationship between metabolic syndrome and colorectal tubular villous adenoma

ObjectiveTo analyze the relationship between colorectal tubular villous adenoma and metabolic syndrome MethodsA total of 271 patients with surgical and pathological diagnosis in Huiyang Hospital Affiliated to Southern Medical University from June 2017 to December 2020 were collected. There were 203 cases of tubular adenoma and 68 cases of tubular villous adenoma. The basic information of fibercolonoscopy, general characteristics, number, pathology and metabolic syndrome related indexes of colorectal polyps were compared between tubular adenoma and tubular villous adenoma patients. Logistic regression analysis was used to analyze the relationship between Yamada classification, maximum polyp diameter, metabolic syndrome related indexes and colorectal tubular villous adenoma. ResultsThe site with the largest cumulative number of polyps, the most prone site of polyps, and the common sites of tubular villous adenoma and tubular adenoma were sigmoid colon. The differences between the patients with colorectal tubular adenoma and tubular villous adenoma were statistically significant in Yamada classification, maximum polyp diameter, serum triglyceride (all P<0.01), but there were no statistically significant differences in hypertension, fatty liver, impaired fasting glucose or diabetes, total cholesterol, serum uric acid level and carcinoembryonic antigen level. Logistic regression analysis showed that Yamada classification Wald χ²=5.756, Exp(B)=2.494, P=0.016] and maximum polyp diameter Wald χ²=23.173, Exp(B)=12.842, P<0.001] were correlated with colorectal tubular villous adenoma, but serum triglyceride level was not correlated with colorectal tubular villous adenoma. ConclusionCompared with patients with tubular adenoma, metabolic syndrome is not directly related to the pathogenesis of colorectal tubular villous adenoma, but polyp diameter and Yamada classification are closely related to the pathogenesis of colorectal tubular villous adenoma.