Characteristics and risk factor analyses of high-grade intraepithelial neoplasia in older patients with colorectal polyps

Table 1 Comparison of population characteristics between high-grade intraepithelial neoplasia group and low-grade intraepithelial neoplasia group, n (%)

Population characteristics	HGIN group (number of cases = 84)	LGIN group (number of cases = 112)	t/χ2	P value
Age (years old)	74.7 ± 6.8	71.4 ± 5.0	3.916	0.000
Sex			0.500	0.479
Male	50 (59.52)	61 (54.46)
Female	34 (40.48)	51 (45.54)
Smoking			1.088	0.297
Yes	32 (38.1)	51 (45.54)
No	52 (61.9)	61 (54.46)
Drinking			1.340	0.247
Yes	43 (51.19)	48 (42.86)
No	41 (48.81)	64 (57.14)
Family history of colorectal cancer			8.588	0.003
Yes	13 (15.48)	4 (3.57)
No	71 (84.52)	108 (96.43)
Diabetes			5.104	0.024
Yes	20 (23.81)	13 (11.61)
No	64 (76.19)	99 (88.39)
Hypertension			2.054	0.152
Yes	23 (27.38)	21 (18.75)
No	61 (72.62)	91 (81.25)
Number of polyps			2.458	0.117
Solitary	78 (92.86)	96 (85.71)
Multiple	6 (7.14)	16 (14.29)

LGIN: Low-grade intraepithelial neoplasia; HGIN: High-grade intraepithelial neoplasia.

Table 2 Comparison of polyp characteristics between high-grade intraepithelial neoplasia group and low-grade intraepithelial neoplasia group, n (%)

Endoscopic features	HGIN group (number of polyps = 93)	LGIN group (number of polyps = 132)	χ2	P value
Polyp site			26.348	0.000
Ascending colon	10 (10.75)	29 (21.97)
Transverse colon	9 (9.68)	32 (24.24)
Descending colon	15 (16.13)	31 (23.48)
Sigmoid	34 (36.56)	27 (20.45)
Rectum	25 (26.88)	13 (9.85)
Endoscopic classification			5.371	0.020
Calyx perpetual	43 (46.24)	41 (31.06)
Calyx deciduous	50 (53.76)	91 (68.94)
Polyp cut area	61 (65.59)		10.369	0.001
≥ 1.0 cm2	61 (65.59)	21 (15.91)
< 1.0 cm2	32 (34.41)	111 (84.09)
Changes in surface color			8.680	0.003
Hyperemia	58 (62.37)	56 (42.42)
Uncongested	35 (37.63)	76 (57.58)
Surface depression			8.051	0.005
Yes	21 (22.6)	4 (3.03)
No	72 (77.4)	128 (96.97)
Pathological results			24.540	0.000
Canalicular adenoma	62 (66.67)	87 (65.91)
Villous tubular adenoma	26 (27.96)	12 (9.09)
Serrated adenoma	2 (2.15)	6 (4.55)
Non-adenomatous polyps	3 (3.23)	27 (20.45)

LGIN: Low-grade intraepithelial neoplasia; HGIN: High-grade intraepithelial neoplasia.

Table 3 Comparison of clinical manifestations between high-grade intraepithelial neoplasia group and low-grade intraepithelial neoplasia group, n (%)

Clinical manifestation	HGIN group (number of cases = 84)	LGIN group (number of cases = 112)	χ2	P value
Bleeding or occult blood			12.435	0.000
Yes	11 (13.10)	1 (0.89)
No	73 (86.9)	111 (99.11)
Constipation			2.904	0.088
Yes	20 (23.81)	16 (14.29)
No	64 (76.19)	96 (85.71)
Abdominal pain or abdominal distension			3.477	0.062
Yes	18 (21.43)	13 (11.61)
No	66 (78.57)	99 (88.39)
Diarrhea			2.667	0.102
Yes	13 (15.48)	9 (8.04)
No	71 (84.52)	103 (91.96)

LGIN: Low-grade intraepithelial neoplasia; HGIN: High-grade intraepithelial neoplasia.

Table 4 The proportion of patients with elevated serum tumor markers in the high-grade intraepithelial neoplasia group and low-grade intraepithelial neoplasia group, n (%)

Tumor marker	HGIN group (number of cases = 84)	LGIN group (number of cases = 112)	χ2	P value
CEA			6.212	0.013
Ascension	17 (20.24)	9 (8.04)
Normal	67 (79.76)	103 (91.96)
CA724			3.519	0.061
Ascension	6 (7.14)	2 (1.79)
Normal	78 (92.86)	110 (98.21)
CA199			13.259	0.000
Ascension	15 (17.86)	3 (2.68)
Normal	69 (82.14)	109 (97.32)
CA242			2.890	0.089
Ascension	4 (4.76)	1 (0.89)
Normal	80 (95.24)	111 (99.11)

LGIN: Low-grade intraepithelial neoplasia; HGIN: High-grade intraepithelial neoplasia; CA199: Cancer antigen 199; CA724: Cancer antigen 724; CA242: Cancer antigen 242; CEA: Carcinoembryonic antigen.

Table 5 Comparison of preoperative health status between high-grade intraepithelial neoplasia group and low-grade intraepithelial neoplasia group

Indicator	HGIN group (number of cases = 84)	LGIN group (number of cases = 112)	t	P value
MNA-SF	9.85 ± 3.27	11.28 ± 2.29	-2.424	0.018
FRAIL	1.51 ± 1.32	0.46 ± 0.81	4.211	0.000

LGIN: Low-grade intraepithelial neoplasia; HGIN: High-grade intraepithelial neoplasia; FRAIL: Fatigue, resistance, ambulation, illness, and loss of weight index.

Table 6 Logistic regression model analysis

Factor	β	SE	Walds	P value	OR	95%CI
Sigmoid colon polyps or rectal polyps	0.504	0.201	6.287	0.000	1.655	1.116	2.455
Pedicled polyps	0.338	0.311	1.181	0.419	1.402	0.762	2.579
≥ 1.0 cm2 polyp	0.411	0.195	4.442	0.044	1.508	1.029	2.210
Polyp surface congestion	0.392	0.311	1.589	0.295	1.480	0.804	2.723
Polyp surface depression	0.604	0.381	2.513	0.185	1.829	0.867	3.860
Villous tubular adenoma	0.477	0.231	4.264	0.048	1.611	1.025	2.534
Age	0.409	0.304	1.810	0.215	1.505	0.830	2.731
Diabetes	0.281	0.261	1.159	0.421	1.324	0.794	2.209
Family history of colon cancer	0.633	0.295	4.604	0.042	1.883	1.056	3.358
Bleeding or occult blood	0.295	0.130	5.149	0.034	1.343	1.041	1.733
Elevated CEA	0.403	0.188	4.595	0.045	1.496	1.035	2.163
Elevated CA199	0.295	0.127	5.396	0.017	1.343	1.047	1.723
MNA-SF	-0.729	0.391	9.272	0.000	0.814	0.695	0.989
FRAIL	0.211	0.436	7.367	0.000	1.493	1.141	1.765
Constant term	1.332	0.914	2.124	0.167	3.789	0.632	22.724

OR: Odds ratio; MNA-SF: Mini nutritional assessment short form; CA199: Cancer antigen 199; CEA: Carcinoembryonic antigen; FRAIL: Fatigue, resistance, ambulation, illness, and loss of weight index.