Risk factors of pathological differences between preoperative biopsy and postoperative specimens in colorectal adenoma complicated with intraepithelial neoplasia
Objective To investigate the risk factors of pathological differences between preoperative biopsy and postoperative specimens for intraepithelial neoplasia of colorectal adenoma.Methods A retrospective cohort study was conducted IN 223 patients with colorectal adenoma,all of whom underwent endoscopic biopsy before surgery and were pathologically diagnosed as intraepithelial neoplasia(IN).After endoscopic therapy,they were divided into unupgraded group and upgraded group according to pathological differences between preoperative biopsy and postoperative specimens.Univariate and multivariate analysis was used to investigate the risk factors for pathological escalation of colorectal adenoma after endoscopic therapy.Results In 223 cases of colorectal adenoma,pathological upgrading occurred in 63 cases(28.3%)after endoscopic treatment.Among the 199 cases of low-grade intraepithelial neoplasia(LGIN)in preoperative biopsy,49 cases were upgraded to high-grade intraepithelial neoplasia(HGIN)after surgery,and 4 cases were upgraded to colorectal cancer(CRC).Among the 24 lesions with HGIN biopsies before surgery,10 lesions were pathologically upgraded to CRC after surgery.Multivariate Logistic regression analysis indicated that adenoma size≥1 cm,long pedicle shape,histological type(villus structure),and metabolic syndrome were independent risk factors for postoperative pathological escalation of colorectal adenoma with IN(P<0.05).Conclusion The size of adenoma≥1 cm,the morphology of long pedicle,histological type(villus structure),and the combination of metabolic syndrome(MS)are independent risk factors for postoperative pathological escalation of colorectal adenoma with IN undergoing endoscopic therapy.
NETL
NSTL
万方数据
