结直肠息肉伴高级别瘤变内镜下切除术后复发因素的分析

Risk factors for polyp recurrence post-endoscopic resection of colorectal polyps with high-grade neoplasia

摘要:

目的 探讨结直肠息肉伴高级别瘤变内镜切除术后息肉复发的危险因素，为临床监测提供参考依据。方法 收集2013年7月－2017年3月该院结直肠息肉伴高级别瘤变行内镜切除术且有术后随访资料的患者67例，统计术后复发情况，并进行回顾性分析。对患者特征和可能影响术后息肉复发的相关因素［性别、年龄、体重指数（BMI）、吸烟史、饮酒史、息肉部位、大小、形态及数目］进行单因素和多因素分析。结果 结直肠息肉伴高级别瘤变内镜切除术后1、2和3年息肉复发率分别为7.5%、17.7%和23.5%。术后3年息肉累计复发率为41.8%，其中高级别瘤变累计复发率为7.5%。高龄、肥胖、直径 > 2.0 cm息肉和多发性息肉的患者术后复发率较高，多因素分析显示息肉数目是息肉复发的独立危险因素（O = 3.191，95%CI：1.056～9.641）。结论 结直肠息肉伴高级别瘤变内镜切除术后息肉复发率较高，且随着随访时间的延长而升高。术前息肉数目是预测息肉复发的重要因素。

Abstract:

Objective To investigate the risk factors for polyp recurrence after endoscopic resection of colorectal polyps with high-grade neoplasia, then provide a reference for clinical mornitoring.Methods We retrospectively collected the data for 67 patients who received endoscopic resection of colorectal polyps with high-grade neoplasia and follow-up from July 2013 to March 2017, and counted polyp recurrence rate after endoscopic resection. Univariate and multivariate analysis were preformed to evaluate association of the colorectal polyp recurrence post-polypectomy with patient characteristics and polyp features, including gender, age, body mass index (BMI), smoking history, drinking history, location, size and number of polyps.Results Polyp recurrence rate in 1~3 years after colorectal polyps with high-grade neoplasia removal were 7.5%, 17.7% and 23.5%, respectively. The 3-year cumulative recurrence rate of polyp was 41.8%, and the recurrence rate of the high-grade neoplasia lesion of which was 7.5%. There was a higher recurrence rate in polyps diameter > 2.0 cm, obesity, advanced age, multiple polyp patients. Multivariate analysis showed the polyps number was an independent predictor of polyp recurrence post-polypectomy (O = 3.191, 95%CI: 1.056 ~ 9.641).Conclusion The polyps recurrence rate is quite high after endoscopic resection of colorectal polyps with high-grade neoplasia, and increases with longer duration of follow-up. The polyps number at baseline colonoscopy is an important predictor of polyps recurrence.