Study on early warning role of rectal aberrant crypt foci of colorectal cancer and progressive adenoma and risk factors

doi:10.3877/cma.j.issn.1674-0793.2016.04.007

Abstract

Abstract:

Objective

To investigate the early warning role of rectal aberrant crypt foci (ACF) for colorectal cancer, progressive adenoma and the related risk factors.

Methods

Clinical data of 564 patients receiving full colonoscopy and rectum staining observation from January 2014 to September 2015 were retrospectively analyzed. According to the bowel examination results, they were divided into normal group, advanced adenoma group and colorectal cancer group. The early warning function and its risk factors were analyzed and discussed.

Results

The number of ACF in progressive adenoma group and colorectal cancer group was significantly higher than the normal group, the difference was statistically significant (P<0.05). ACF classification showed progressive adenoma ACF grade Ⅲ patients accounted for larger proportion of patients with grade Ⅲ, colorectal cancer patients more ACF grade Ⅱ and Ⅲ, and ACF Ⅱ stage patients accounted for a higher proportion of patients with all ACF grade Ⅱ. Age, smoking, coronary heart disease and the application of aspirin were relevant factors in patients with ACF (P <0.05). Multivariate Logistic regression analysis showed that age> 60 years and smoking were independent risk factors in patients with ACF, while aspirin was a protective factor (P<0.05).

Conclusions

Grade Ⅲ ACF patients are prone to develop progressive adenoma and colorectal cancer, grade Ⅱ patients are with a higher risk of colorectal cancer. ACF patients are with risk factors for older age, smoking, while taking aspirin as a protective factor.

Key words: Colorectal neoplasms, Aberrant crypt foci, Risk factors, Adenoma

Chunguang Hou, Lin Yang. Study on early warning role of rectal aberrant crypt foci of colorectal cancer and progressive adenoma and risk factors[J]. Chinese Archives of General Surgery(Electronic Edition), 2016, 10(04): 260-263.

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References 15

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组别	例数	0级(n=155)	Ⅰ级(n=192)	Ⅱ级(n=112)	Ⅲ级(n=105)
进展型腺瘤组	113	16(10.32)	26(13.54)	27(24.11)	44(41.90)
结直肠癌组	168	14(9.03)	38(19.79)	58(51.78)	58(55.24)
正常组	283	125(80.65)	128(66.67)	27(24.11)	3(2.86)

组别	例数	0级(n=155)	Ⅰ级(n=192)	Ⅱ级(n=112)	Ⅲ级(n=105)
进展型腺瘤组	113	16(10.32)	26(13.54)	27(24.11)	44(41.90)
结直肠癌组	168	14(9.03)	38(19.79)	58(51.78)	58(55.24)
正常组	283	125(80.65)	128(66.67)	27(24.11)	3(2.86)

因素		例数	ACF发生情况［n(%)］	χ²值	P值
性别		?	?	?	?
?	男	325	237(72.92)	1.786	0.172
?	女	239	172(71.97)	1.786	0.172
BMI(kg/m²)		?	?	?	?
?	<18.5	52	36(69.23)	?	?
?	18.5~25.0	393	283(72.01)	1.603	0.198
?	>25.0	119	90(75.63)	?	?
年龄（岁）		?	?	?	?
?	<40	92	40(43.48)	?	?
?	40~60	316	231(73.10)	9.367	0.001^a
?	>60	156	138(88.46)	?	?
家族肠癌史		?	?	?	?
?	有	21	16(76.19)	1.323	0.250
?	无	543	393(72.38)	1.323	0.250
吸烟		?	?	?	?
?	是	172	143(83.14)	7.982	0.007 ^a
?	否	392	266(67.86)	7.982	0.007 ^a
饮酒		?	?	?	?
?	有	101	75(74.26)	2.538	0.112
?	无	463	334(72.14)	2.538	0.112
糖尿病		?	?	?	?
?	有	22	17(77.27)	2.283	0.147
?	无	542	392(72.32)	2.283	0.147
冠心病		?	?	?	?
?	有	35	29(82.86)	3.915	0.041 ^a
?	无	529	380(71.83)	3.915	0.041 ^a
服用阿司匹林		?	?	?	?
?	是	12	8(66.67)	4.458	0.034 ^a
?	否	552	401(72.64)	4.458	0.034 ^a

因素		例数	ACF发生情况［n(%)］	χ²值	P值
性别		?	?	?	?
?	男	325	237(72.92)	1.786	0.172
?	女	239	172(71.97)	1.786	0.172
BMI(kg/m²)		?	?	?	?
?	<18.5	52	36(69.23)	?	?
?	18.5~25.0	393	283(72.01)	1.603	0.198
?	>25.0	119	90(75.63)	?	?
年龄（岁）		?	?	?	?
?	<40	92	40(43.48)	?	?
?	40~60	316	231(73.10)	9.367	0.001^a
?	>60	156	138(88.46)	?	?
家族肠癌史		?	?	?	?
?	有	21	16(76.19)	1.323	0.250
?	无	543	393(72.38)	1.323	0.250
吸烟		?	?	?	?
?	是	172	143(83.14)	7.982	0.007 ^a
?	否	392	266(67.86)	7.982	0.007 ^a
饮酒		?	?	?	?
?	有	101	75(74.26)	2.538	0.112
?	无	463	334(72.14)	2.538	0.112
糖尿病		?	?	?	?
?	有	22	17(77.27)	2.283	0.147
?	无	542	392(72.32)	2.283	0.147
冠心病		?	?	?	?
?	有	35	29(82.86)	3.915	0.041 ^a
?	无	529	380(71.83)	3.915	0.041 ^a
服用阿司匹林		?	?	?	?
?	是	12	8(66.67)	4.458	0.034 ^a
?	否	552	401(72.64)	4.458	0.034 ^a

参数	β	标准误差	Wald值	P值OR	95% CI
年龄>60岁	1.771	0.543	10.667	0.001 5.882	2.031~17.035
吸烟	1.937	0.616	9.888	0.002 6.932	2.074~23.189
冠心病	0.578	1.006	0.330	0.565 1.783	0.248~12.819
服用阿司匹林	1.259	0.541	5.418	0.020 3.522	1.220~10.168

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