Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2024; 16(10): 4129-4137
Published online Oct 15, 2024. doi: 10.4251/wjgo.v16.i10.4129
Characteristics and risk factor analyses of high-grade intraepithelial neoplasia in older patients with colorectal polyps
Xin Zhang, Ying Wang, Tong Zhu, Jian Ge, Jun-Hua Yuan
Xin Zhang, Ying Wang, Tong Zhu, Jun-Hua Yuan, Department of Geriatric Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
Jian Ge, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
Author contributions: Zhang X and Wang Y were the guarantor and designed the study; Zhang X, Zhu T, and Yuan JH participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Zhang X, Ge J and Yuan JH revised the article critically for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the Science and Research Office of Shandong First Medical University Affiliated Provincial Hospital (approved number SWYX: No. 2024-294).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
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: Jun-Hua Yuan, Doctor, Professor, Department of Geriatric Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Huaiyin District, Jinan 250021, Shandong Province, China. yjh717299@126.com
Received: July 24, 2024
Revised: August 13, 2024
Accepted: September 5, 2024
Published online: October 15, 2024
Processing time: 63 Days and 22.2 Hours
Abstract
BACKGROUND

According to the degree of intradermal neoplasia in the colorectal exhalation, it can be divided into two grades: Low-grade intraepithelial neoplasia (LGIN) and high-grade intraepithelial neoplasia (HGIN). Currently, it is difficult to accurately diagnose LGIN and HGIN through imaging, and clinical diagnosis depends on postoperative histopathological diagnosis. A more accurate method for evaluating HGIN preoperatively is urgently needed in the surgical treatment and nursing intervention of colorectal polyps.

AIM

To explore the characteristics and risk factors of HGIN in older patients with colorectal polyps.

METHODS

We selected 84 older patients diagnosed with HGIN as the HGIN group (n = 95 colonic polyps) and 112 older patients diagnosed with LGIN as the LGIN group (n = 132 colonic polyps) from Shandong Provincial Hospital Affiliated to Shandong First Medical University. The endoscopic features, demographic characteristics, and clinical manifestations of the two patient groups were compared, and a logistic regression model was used to analyze the risk factors for HGIN in these patients.

RESULTS

The HGIN group was older and had a higher number of sigmoid colon polyps, rectal polyps, pedunculated polyps, polyps ≥ 1.0 cm in size, polyps with surface congestion, polyps with surface depression, and polyps with villous/tubular adenomas, a higher proportion of patients with diabetes and a family history of colorectal cancer, patients who experienced rectal bleeding or occult blood, patients with elevated carcinoembryonic antigen (CEA) and cancer antigen 199 (CA199), and lower nutritional levels and higher frailty levels. The polyp location (in the sigmoid colon or rectum), polyp diameter (≥ 1.0 cm), pathological diagnosis of (villous/tubular adenoma), family history of colorectal cancer, rectal bleeding or occult blood, elevated serum CEA and CA199 levels, lower nutritional levels and higher frailty levels also are independent risk factors for HGIN.

CONCLUSION

The occurrence of high-grade neoplastic transformation in colorectal polyps is closely associated with their location, size, villous/tubular characteristics, family history, elevated levels of tumor markers, and lower nutritional levels and higher frailty levels.

Keywords: Elderly; Colorectal polyps; High-grade intraepithelial neoplasia; Low-grade intraepithelial neoplasia; Risk factors

Core Tip: Elderly patients diagnosed with colorectal polyps admitted to our hospital from January 2021 to December 2023 were included in the study. High-grade intraepithelial neoplasia characteristics and risk factors of elderly colorectal polyps were analyzed, to provide references for early screening, monitoring and treatment of colorectal polyps in the elderly. Studies have found that the occurrence of high-grade neoplasia in colorectal polyps is closely related to its location, size, villous characteristics, family history, and increased level of tumor markers. Based on these factors, it was found that the early diagnosis and treatment of patients with colorectal polyps could be made, which is of great significance to prevent high-grade neoplasia and even further malignant transformation of polyps in these patients.