颗粒型结直肠侧向发育型肿瘤癌变相关危险因素研究
发布时间：2018-11-27 06:49
【摘要】：目的:研究颗粒型结直肠侧向发育型肿瘤(granular colorectal laterally spreading tumor,LST-G)的临床病理学特点,分析LST-G的癌变相关危险因素,为临床诊疗提供指导及参考。方法:对2013年10月至2016年11月间在大连医科大学附属第一医院诊治的65例LST-G患者资料进行回顾性研究,所有患者均行内镜下黏膜切除术(EMR)或内镜黏膜下剥离术(ESD)治疗,分析其癌变率。患者的一般临床资料包括年龄、性别、肠癌家族史、有无吸烟及饮酒史;患者的LST-G病变性状特征包括病变的直径大小、病变表面结节大小(指最大结节或主要结节的大小)及部位。卡方检验或t检验分析出可能的危险因素,多因素Logistic回归分析引起癌变的独立危险因素。结果:1.共有65例LST-G纳入研究,其中33例发生癌变(50.8%),32例为非癌变(49.2%)。2.一般临床资料比较:癌变组和非癌变组间年龄(p=0.595)、性别(p=0.089)、有无吸烟史(p=0.063)、有无饮酒史(p=0.097)均无明显差异;有结肠癌家族史的患者癌变率(83.3%)显著高于无结肠癌家族史的患者(43.4%)(p=0.029)。3.病变的性状特征比较:癌变组和非癌变组间在病变部位(p=0.103)方面无显著性差异;癌变组的病变直径(26.3±9.8mm)明显高于非癌变组(19.8±6.8mmm)(p=0.003),且直径分组间有显著性差异(p=0.001);癌变组的LST-G表面结节(指最大结节或主要结节)直径明显大于非癌变组(p0.001);4.多因素Logistic回归分析显示,LST-G发生癌变的独立危险因素为:病变直径分组(p=0.034)、结节直径分组(p0.001)以及是否有肠癌家族史(p=0.026),其OR值顺序为:结节直径分组(29.722)肠癌家族史(17.090)病变直径分组(0.034)。结论:1.患者的一般临床资料中:年龄、性别、有无吸烟史及有无饮酒史与LST-G癌变无关;结肠癌家族史是LST-G发生癌变的危险因素。2.LST-G病变的性状特征中:病变部位与LST-G发生癌变无明显相关性;病变的直径、病变表面结节的直径均为LST-G发生癌变的危险因素。3.多因素Logistic回归分析显示:病变表面结节(指最大结节或主要结节)直径比肠癌家族史及病变直径对LST-G是否癌变具有更高的预测价值,即结节直径越大,LST-G的癌变率越高。
[Abstract]:Objective: to study the clinicopathological characteristics of granular colorectal lateral development tumor (granular colorectal laterally spreading tumor,LST-G) and to analyze the risk factors of LST-G carcinogenesis, and to provide guidance and reference for clinical diagnosis and treatment. Methods: from October 2013 to November 2016, the data of 65 patients with LST-G in the first affiliated Hospital of Dalian Medical University were retrospectively studied. All patients were treated with endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). The general clinical data of the patients included age, sex, family history of bowel cancer, history of smoking and drinking. The pathological characteristics of LST-G include the diameter of the lesion, the size of the lesion surface (the size of the largest or main nodule) and the location of the lesion. The possible risk factors were analyzed by chi-square test or t test, and the independent risk factors of carcinogenesis were analyzed by multivariate Logistic regression analysis. Results: 1. A total of 65 cases of LST-G were included in the study, of which 33 cases (50.8%) developed carcinogenesis and 32 cases (49.2%) were non-cancerous. There were no significant differences in age, sex (p0.089), smoking history (p0.063) and drinking history (p0.097) between cancerous group and non-cancerous group (p0. 595), sex (p0. 089), smoking history (p0. 063) and drinking history (p0. 097). The incidence of cancer in patients with family history of colon cancer (83.3%) was significantly higher than that in patients without family history of colon cancer (43.4%) (p 0.029). There was no significant difference between the canceration group and the non-cancerous group in the location of lesion (p0. 103). The diameter of lesion in cancer group (26. 3 卤9.8mm) was significantly higher than that in non cancerous group (19. 8 卤6.8mmm) (p0. 003), and there was significant difference in diameter between groups (p0. 001). The diameter of LST-G surface nodules in carcinogenesis group was significantly larger than that in non-cancerous group (P 0. 001). Multivariate Logistic regression analysis showed that the independent risk factors for carcinogenesis in LST-G were as follows: lesion diameter group (p0. 034), nodular diameter group (p0. 001), and family history of colorectal cancer (p0. 026). The order of OR was: nodular diameter group (29.722), colorectal cancer family history (17.090), lesion diameter group (0.034). Conclusion: 1. Age, sex, smoking history and drinking history were not associated with LST-G carcinogenesis. The family history of colon cancer was the risk factor of carcinogenesis in LST-G. There was no significant correlation between the location of lesion and the carcinogenesis of LST-G in 2.LST-G. The diameter of lesion and the diameter of lesion surface were all risk factors for carcinogenesis of LST-G. Multivariate Logistic regression analysis showed that the diameter of the lesion surface nodules (the largest or the main nodules) had a higher predictive value for the carcinogenesis of LST-G than the family history of colorectal cancer and the diameter of the lesions, that is, the larger the diameter of the nodules, the greater the diameter of the nodules. The higher the canceration rate of LST-G.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34
，
本文编号：2359750
[Abstract]:Objective: to study the clinicopathological characteristics of granular colorectal lateral development tumor (granular colorectal laterally spreading tumor,LST-G) and to analyze the risk factors of LST-G carcinogenesis, and to provide guidance and reference for clinical diagnosis and treatment. Methods: from October 2013 to November 2016, the data of 65 patients with LST-G in the first affiliated Hospital of Dalian Medical University were retrospectively studied. All patients were treated with endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). The general clinical data of the patients included age, sex, family history of bowel cancer, history of smoking and drinking. The pathological characteristics of LST-G include the diameter of the lesion, the size of the lesion surface (the size of the largest or main nodule) and the location of the lesion. The possible risk factors were analyzed by chi-square test or t test, and the independent risk factors of carcinogenesis were analyzed by multivariate Logistic regression analysis. Results: 1. A total of 65 cases of LST-G were included in the study, of which 33 cases (50.8%) developed carcinogenesis and 32 cases (49.2%) were non-cancerous. There were no significant differences in age, sex (p0.089), smoking history (p0.063) and drinking history (p0.097) between cancerous group and non-cancerous group (p0. 595), sex (p0. 089), smoking history (p0. 063) and drinking history (p0. 097). The incidence of cancer in patients with family history of colon cancer (83.3%) was significantly higher than that in patients without family history of colon cancer (43.4%) (p 0.029). There was no significant difference between the canceration group and the non-cancerous group in the location of lesion (p0. 103). The diameter of lesion in cancer group (26. 3 卤9.8mm) was significantly higher than that in non cancerous group (19. 8 卤6.8mmm) (p0. 003), and there was significant difference in diameter between groups (p0. 001). The diameter of LST-G surface nodules in carcinogenesis group was significantly larger than that in non-cancerous group (P 0. 001). Multivariate Logistic regression analysis showed that the independent risk factors for carcinogenesis in LST-G were as follows: lesion diameter group (p0. 034), nodular diameter group (p0. 001), and family history of colorectal cancer (p0. 026). The order of OR was: nodular diameter group (29.722), colorectal cancer family history (17.090), lesion diameter group (0.034). Conclusion: 1. Age, sex, smoking history and drinking history were not associated with LST-G carcinogenesis. The family history of colon cancer was the risk factor of carcinogenesis in LST-G. There was no significant correlation between the location of lesion and the carcinogenesis of LST-G in 2.LST-G. The diameter of lesion and the diameter of lesion surface were all risk factors for carcinogenesis of LST-G. Multivariate Logistic regression analysis showed that the diameter of the lesion surface nodules (the largest or the main nodules) had a higher predictive value for the carcinogenesis of LST-G than the family history of colorectal cancer and the diameter of the lesions, that is, the larger the diameter of the nodules, the greater the diameter of the nodules. The higher the canceration rate of LST-G.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34
，
本文编号：2359750
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