大肠息肉肠镜下表现及其癌变与TG、NLR的关系

doi:10.7517/issn.1674-0475.210919

摘要/Abstract

摘要： 本研究探讨大肠息肉肠镜表现及病理,以及与甘油三酯(TG)、中性粒细胞与淋巴细胞比值(NLR)的相关性。选取422例大肠息肉患者为研究对象,分析患者肠镜下表现、病理分布特点,同时分析息肉癌变和非息肉癌变患者TG、NLR等指标差异。共检出息肉1084枚,息肉以无蒂息肉为主;病理显示腺瘤性息肉较多;息肉癌变组患者年龄明显高于非息肉癌变组患者(P<0.05);息肉癌变组总胆固醇(TC)、TG、血尿酸(SUA)和NLR明显高于非息肉癌变组(P<0.05),而血小板计数(PLT)明显低于非息肉癌变组(P<0.05);Logistic回归分析结果显示,年龄、TG、NLR是息肉癌变的影响因素(P<0.05)。大肠息肉主要为无蒂息肉,病理主要为腺瘤性息肉;息肉癌变受患者年龄、TG、NLR水平的影响。

关键词: 大肠息肉, 肠镜, 病理, 癌变, 甘油三酯, 中性粒细胞与淋巴细胞比值

Abstract: This study investigated the colonoscopy and pathology of colorectal polyps, and its correlation with triglyceride (TG), neutrophil lymphocyte ratio (NLR). 422 patients with colorectal polyps were selected as the subjects, the colonoscopic manifestations and pathological distribution characteristics of the patients were analyzed, and the differences of TG, NLR and other indicators between patients with polyp canceration and non polyp canceration were analyzed. A total of 1084 polyps were detected, most of which were sessile polyps. Pathology showed more adenomatous polyps. The age of polyp canceration group was significantly higher than that of non polyp canceration group (P<0.05). The total cholesterol (TC), triglyceride (TG), serum uric acid (SUA) and NLR were significantly higher than that in non polyp canceration group (P<0.05), while platelet count (PLT) was significantly lower than that in non polyp canceration group (P< 0.05). Logistic regression analysis showed that age, TG and NLR were the influencing factors of polyp carcinogenesis (P<0.05). Colorectal polyps are mainly sessile polyps, and adenomatous polyps are the main pathological types. The canceration of polyps are affected by age, TG and NLR levels.

Key words: colorectal polyps, colonoscopy, pathology, canceration, triglyceride, neutrophil lymphocyte ratio

施媛, 杨倩, 张仪, 王亚雷. 大肠息肉肠镜下表现及其癌变与TG、NLR的关系[J]. 影像科学与光化学, 2022, 40(2): 382-386.

SHI Yuan, YANG Qian, ZHANG Yi, WANG Yalei. Colonoscopic Manifestations of Colorectal Polyps and Its Carcinogenesis Relationship with TG and NLR[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(2): 382-386.

参考文献

[1] 李江波, 孙聪, 孙常波, 等. 内镜下黏膜切除术治疗大肠广基息肉患者的临床疗效评价[J]. 中国药物与临床, 2019, 19(7):1095-1096.
[2] 毛文昕, 钟子劭, 黄穗平, 等. 大肠息肉发病位置及中医证候特点分析[J]. 广州中医药大学学报, 2020, 37(5):818-822.
[3] 潘程宇, 滑永志. 幽门螺旋杆菌感染与大肠息肉的相关性[J]. 临床与病理杂志, 2020, 40(3):616-619.
[4] 徐志刚, 倪吉凯, 吴文江. 肠镜下大肠息肉漏诊相关因素的分析与思考[J]. 结直肠肛门外科, 2020, 26(1):128-130.
[5] 周璀, 梁钰, 侯利丹, 等. 结直肠息肉与血脂异常关系的回顾性研究[J]. 国际消化病杂志, 2020, 40(5):314-318.
[6] 蒋元烨, 田继云, 金磊, 等. NLR及PLR对预测大肠息肉复发的临床意义[J]. 重庆医学, 2017, 36(46):121-124.
[7] Hardy R. Molecualr basis for risk factors in colorectal cancer-genetic syndromes, adenomatous colorectal polyps and ulcerative colitis[J]. Advances in Cancer Research, 2001, 70(70):179-222.
[8] Molmenti C L, Kolb J M, Karlitz J J. Advanced colorectal polyps on colonoscopy:A trigger for earlier screening of family members[J]. The American Journal of Gastroenterology, 2020, 115(3):1-2.
[9] Min M, Su S, He W, et al. Computer-aided diagnosis of colorectal polyps using linked color imaging colonoscopy to predict histology[J]. Scientific Reports, 2019, 9(1):2881-2882.
[10] Djinbachian R, Marchand E, Pohl H, et al. Optical diagnosis of colorectal polyps:A randomized controlled trial comparing endoscopic image enhancing modalities[J]. Gastrointestinal Endoscopy, 2020, 93(3):712-719.
[11] 王晶, 殷云勤, 文静. 2942例大肠息肉的临床特点及结肠癌检出率分析[J]. 中国现代医生, 2016, 54(1):81-83.
[12] 于晓娜, 邵顺子, 沈才飞, 等. 大肠息肉癌变相关危险因素分析[J]. 重庆医学, 2014, 43(29):3866-3868.
[13] Tamura Y, Ohta H, Torisu S, et al. Markedly increased expression of interleukin-8 in the colorectal mucosa of inflammatory colorectal polyps in miniature dachshunds[J]. Veterinary Immunology & Immunopathology, 2013, 156(1-2):32-42.
[14] 刘利利, 常冰梅, 刘海义, 等. 中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值变化在直肠癌新辅助治疗中的意义[J]. 肿瘤研究与临床, 2020, 32(3):145-148.
[15] Pai R K, Bettington M, Srivastava A, et al. An update on the morphology and molecular pathology of serrated colorectal polyps and associated carcinomas[J]. Modern Pathology, 2019, 32(10):1390-1415.
[16] 朱玉, 戴夫, 彭琼. 胃肠息肉患者血脂水平影响因素及相关性分析[J]. 医学信息, 2019, 32(2):79-82.
[17] 朱姝. 胃息肉与大肠息肉临床和病理特征分析[J]. 河北医学, 2017, 23(5):756-759.
[18] Tomizawa M, Shinozaki F, Hasegawa R, et al. Higher serum uric acid levels and advanced age are associated with an increased prevalence of colorectal polyps[J]. Biomedical Reports, 2015, 3(5):637-639.
[19] Naji W Q, Zhu H, Xu X. The correlation between serum uric acid and serum lipids in the patients with colorectal polyps[J]. IOSR Journal of Dental and Medical Sciences, 2016, 15(5):17-21.
[20] Liu B, Wen P, Gu X, et al. Elevated serum triglyceride predicts recurrence of colorectal polyps in patients with advanced adenomas[J]. Lipids in Health and Disease, 2020, 19(1):211-212.