Simple Clinical Risk Score Identifies Patients with Serrated Polyps in Routine Practice
Simple Clinical Risk Score Identifies Patients with Serrated Polyps in Routine Practice
复制标题
DOI：
10.1158/1940-6207.capr-13-0022
复制
发表时间：
2013-08-01
影响因子：
3.3
通讯作者：
Sanduleanu, Silvia
中科院分区：
文献类型：
--
作者：
Bouwens, Marielle W. E.;Winkens, Bjorn;Sanduleanu, Silvia
大的、近端或发育不良的（LPD）锯齿状息肉（SP）需要准确的内镜识别和切除，因为它们可能发展为结直肠癌。因此，我们研究了>= 1 LPD SP的风险因素。我们开发并验证了一个简单的SP风险评分，作为改进其检测的潜在工具。我们回顾了选择性结肠镜检查患者的临床、内镜和组织学特征。获得一份自我管理的问卷。我们进行了逻辑回归分析，以确定>= 1 LPD SP的独立危险因素，并将重要变量纳入临床评分。我们随后在一个验证队列中测试了SP评分的表现。我们在推导中检查了2244名患者，在验证队列中检查了2402名患者；>= 1 LPD SP分别为6.3%和8.2%。LPD SPs的独立危险因素是年龄大于50岁[OR 2.2；95%置信区间（CI）， 1.3-3.8；P = 0.004]、锯齿状息肉的个人病史（OR 2.6; 95% CI, 1.3-4.9; P = 0.005）、目前吸烟（OR 2.2; 95% CI, 1.4-3.6; P = 0.001）和非每日/不服用阿司匹林（OR 1.8; 95% CI, 1.1-3.0; P = 0.016）。在验证队列中，与评分< 5分的患者相比，SP评分为bb0.5分的患者患LPD SPs的几率增加3.0倍。在本研究中，年龄超过50岁，个人有锯齿状息肉病史，目前吸烟，非每日或不使用阿司匹林是LPD SPs的独立危险因素。SP评分可能有助于内窥镜医师检测此类病变。
Large, proximal, or dysplastic (LPD) serrated polyps (SP) need accurate endoscopic recognition and removal as these might progress to colorectal cancer. Herewith, we examined the risk factors for having >= 1 LPD SP. We developed and validated a simple SP risk score as a potential tool for improving their detection. We reviewed clinical, endoscopic, and histologic features of serrated polyps in a study of patients undergoing elective colonoscopy (derivation cohort). A self-administered questionnaire was obtained. We conducted logistic regression analyses to identify independent risk factors for having >= 1 LPD SP and incorporated significant variables into a clinical score. We subsequently tested the performance of the SP score in a validation cohort. We examined 2,244 patients in the derivation and 2,402 patients in the validation cohort; 6.3% and 8.2% had >= 1 LPD SP, respectively. Independent risk factors for LPD SPs were age of more than 50 years [OR 2.2; 95% confidence interval (CI), 1.3-3.8; P = 0.004], personal history of serrated polyps (OR 2.6; 95% CI, 1.3-4.9; P = 0.005), current smoking (OR 2.2; 95% CI, 1.4-3.6; P = 0.001), and nondaily/no aspirin use (OR 1.8; 95% CI, 1.1-3.0; P = 0.016). In the validation cohort, a SP score > 5 points was associated with a 3.0-fold increased odds for LPD SPs, compared with patients with a score < 5 points. In the present study, age of more than 50 years, a personal history of serrated polyps, current smoking, and nondaily/no aspirin use were independent risk factors for having LPD SPs. The SP score might aid the endoscopist in the detection of such lesions.