摘要
[目的]通过对结直肠进展期腺瘤(ACA)危险因素的分析及中性粒细胞/淋巴细胞比值(NLR)对其发生风险的影响,以针对具有这些危险因素的患者进行筛查,便于及早发现和干预ACA,从而降低结直肠癌发生率。[方法]将结直肠腺瘤患者642例,根据ACA的定义分为ACA组和非ACA组,比较2组间临床资料的差异,并进行ACA危险因素的多因素Logistic回归分析,进一步采用一比一PSM分析,对匹配组使用Logistic回归模型分析。[结果]在单因素分析中,ACA组与非ACA组在年龄、吸烟史、体质指数(BMI)、白细胞计数(WBC)、中性粒细胞计数(N)、淋巴细胞计数(L)和低密度脂蛋白(LDL-C)方面比较差异有统计学意义(P<0.05)。在多因素分析中,男性和有吸烟史者患ACA的风险增加,且ACA的风险随着年龄、BMI以及N/L比值(NLR)的增加而升高。进一步一对一倾向评分匹配(PSM)分析显示,NLR对ACA风险的影响仍然显著,且ACA风险随NLR的升高而增加(OR=1.861;95%CI:1.312~2.639;P<0.001)。[结论]建议将男性、高龄、肥胖、有吸烟史、NLR升高人群作为ACA的筛查重点,以便及早发现和干预ACA,从而降低结直肠癌发生率。
[Objective]By analyzing the risk factors associated with colorectal advanced adenoma(ACA)and assessing the impact of neutrophil-to-lymphocyte ratio(NLR)on its risk,this study aimed to facilitate the identification of patients with these risk factors,enabling early detection and intervention in advanced adenoma,ultimately reducing the incidence of colorectal cancer.[Methods]A total of 642 patients with colo-rectal adenoma were collected,and were divided into ACA group and non-ACA group according to the defi-nition of ACA.[Results]In univariate analysis,there were statistically significant differences between the ACA and non-ACA groups in terms of age,smoking history,body mass index(BMI),white blood cell count(WBC),neutrophil count(N),lymphocyte count(L),and low-density lipoprotein(LDL-C)(P<O.05).In multivariate analysis,male and those with a history of smoking were at increased risk of ACA,and the risk of ACA increased with age,BMI,and NLR.Further one-to-one propensity score matching(PSM)analysis showed that the impact of NLR on the risk of ACA was still significant,and the risk of ACA increased with the increase of NLR(OR=1.861;95%CI:1.312-2.639;P<0.001).[Conclusion]It is recommended to prioritize the screening of ACA in the elderly population,individuals with overweight,a history of smok-ing,and those with elevated NLR,with particular emphasis on individuals exhibiting an elevated NLR.This approa aims to facilitate early detection and intervention for advanced adenomas,ultimately reducing theincidence of colorectal cancer.
作者
马娟秀
陈睆月
蔺蓉
MA Juan-aiu;CHEN Huan-yue;LIN Rong(Department of Gastroenterology,Union Hospital of Huazhong Science and Technology,430022 Wuhan,Hubei,China)
出处
《临床消化病杂志》
2025年第3期144-148,共5页
Chinese Journal of Clinical Gastroenterology
基金
国家自然科学基金(No:81900580)。
