Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Predicting colorectal adenomatous polyps in patients with chronic liver disease: A novel nomogram
Yu-Qin Li, Wen-Tao Kuai, Lin Chen, Ming-Hui Zeng, Xue-Mei Tao, Jia-Xin Han, Yue-Kui Wang, Lian-Xin Xu, Li-Ying Ge, Yong-Gang Liu, Shuang Li, Liang Xu, Yu-Qiang Mi
Yu-Qin Li, Ming-Hui Zeng, Xue-Mei Tao, Jia-Xin Han, Yue-Kui Wang, Lian-Xin Xu, Li-Ying Ge, Liang Xu, Yu-Qiang Mi, Clinical School of the Second People’s Hospital, Tianjin Medical University, Tianjin 300192, China
Wen-Tao Kuai, Lin Chen, Liang Xu, Yu-Qiang Mi, Department of Hepatology, Tianjin Second People’s Hospital, Tianjin 300192, China
Yong-Gang Liu, Department of Pathology, Clinical School of the Second People’s Hospital, Tianjin 300110, China
Shuang Li, Endoscopy Center, Tianjin Second People’s Hospital, Tianjin 300192, China
Co-first authors: Yu-Qin Li and Wen-Tao Kuai.
Co-corresponding authors: Liang Xu and Yu-Qiang Mi.
Author contributions: Li YQ and Kuai WT conducted formal analysis and investigation, they contributed equally to this article, they are the co-first authors of this manuscript; Li YQ wrote the original draft; Mi YQ, Xu L, and Li S designed the study and acquired funding; Li YQ and Xu L developed the methodology; Mi YQ and Xu L contributed equally to this article as the co-corresponding authors; Chen L, Zeng MH, Tao XM, Wang YK, and Han JX participated in review and editing; Li YQ, Xu LX, and Ge LY collected the data; Liu YG provided pathological guidance for colorectal polyps; Li S provided endoscopic guidance.
Supported by the National Natural Science Foundation of China, No. 62375202; Natural Science Foundation of Tianjin, No. 23JCYBJC00950; Tianjin Health Science and Technology Project Key Discipline Special, No. TJWJ2022XK034; and Research Project in Key Areas of Traditional Chinese Medicine in 2024, No. 2024022.
Institutional review board statement: This study has been reviewed and approved by the Ethics Committee of Tianjin Second People’s Hospital.
Informed consent statement: The requirement for written informed consent was not needed due to retrospective design of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data involved in this study can be obtained from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Yu-Qiang Mi, MD, Professor, Department of Hepatology, Tianjin Second People’s Hospital, No. 7 Sudi South Road, Xuefu Street, Nankai District, Tianjin 300192, China.
yuqiangmi68@163.com
Received: July 15, 2024
Revised: October 29, 2024
Accepted: November 11, 2024
Published online: January 14, 2025
Processing time: 155 Days and 19.9 Hours
BACKGROUND
Colorectal polyps are commonly observed in patients with chronic liver disease (CLD) and pose a significant clinical concern because of their potential for malignancy.
AIM
To explore the clinical characteristics of colorectal polyps in patients with CLD, a nomogram was established to predict the presence of adenomatous polyps (AP).
METHODS
Patients with CLD who underwent colonoscopy at Tianjin Second People’s Hospital from January 2020 to May 2023 were evaluated. Clinical data including laboratory results, colonoscopy findings, and pathology reports were collected. Key variables for the nomogram were identified through least absolute shrinkage and selection operator regression, followed by multivariate logistic regression. The performance of the model was evaluated using the area under the receiver area under curve, as well as calibration curves and decision curve analysis.
RESULTS
The study enrolled 870 participants who underwent colonoscopy, and the detection rate of AP in patients with CLD was 28.6%. Compared to individuals without polyps, six risk factors were identified as predictors for AP occurrence: Age, male sex, body mass index, alcohol consumption, overlapping metabolic dysfunction-associated steatotic liver disease, and serum ferritin levels. The novel nomogram (AP model) demonstrated an area under curve of 0.801 (95% confidence interval: 0.756-0.845) and 0.785 (95% confidence interval: 0.712-0.858) in the training and validation groups. Calibration curves indicated good agreement among predicted and actual probabilities (training: χ2 = 11.860, P = 0.157; validation: χ2 = 7.055, P = 0.530). The decision curve analysis underscored the clinical utility of the nomogram for predicting the risk of AP.
CONCLUSION
The AP model showed reasonable accuracy and provided a clinical foundation for predicting the occurrence of AP in patients with CLD, which has a certain predictive value.
Core Tip: This study is the first effort to develop and validate a predictive model for assessing the risk of adenomatous polyps in patients with chronic liver disease. Based on six risk factors, the developed adenomatous polyps model will function as an effective means of identifying and stratifying patients undergoing management for chronic liver disease, thereby helping to reduce the risk of colorectal cancer in these individuals.
