Abstract:

Objective

To investigate the influencing factors of colorectal polyp recurrence and explore the role of BMI in colorectal polyp recurrence.

Methods

A total of 317 colorectal polyp patients who underwent endoscopic resection at the Department of Gastroenterology， Beijing Haidian Hospital， from November 2018 to August 2022， were included. Based on postoperative polyp recurrence， the patients were divided into a recurrence group （237 patients） and a non-recurrence group （80 patients）. Clinical data of the patients were collected， including demographic， history of diseases， and polyp characteristics， and influencing factors of colorectal polyp recurrence and their difference between different groups by BMI levels were analyzed.

Results

The univariate analysis showed that there were significant differences （P＜0.05） between the recurrence group and the non-recurrence group in terms of gender （χ²=7.783， P=0.005）， age （Z=2.541，P=0.011）， history of hypertension （χ²=5.071， P=0.024）， history of diabetes （χ²=9.889， P=0.002）， history of coronary heart disease （χ²=4.746， P=0.029）， smoking history （χ²=8.375， P=0.004）， number of polyps （Z=5.995，P＜0.001）， and the largest polyp location （χ²=16.050， P=0.003）. Multivariate logistic regression analysis indicated that diabetes history ［OR: 2.949， 95%CI: （1.064， 8.171）］， number of polyps ［OR: 1.532， 95%CI:（1.261， 1.861）］， and the growth site of the largest polyp in the transverse colon ［OR: 2.765， 95%CI: （1.046， 7.308）］and rectum ［OR: 3.075， 95%CI: （1.239， 7.634）］were independent factors for colorectal polyp recurrence（P＜0.05）. Further stratified analysis revealed that factors， such as diabetes history， number of polyps and histological pattern， and the growth site of the largest polyp had statistically significant effects on recurrence in the BMI≥24 kg/m² group.

Conclusion

Colorectal polyp recurrence is closely related to factors， such as diabetes history， number of polyps， and the growth site of the largest polyp. The risk factors of recurrence differ in patients with different BMI levels. In patients with normal or lower BMI， the recurrence risk is mainly influenced by number of polyps and smoking， while in overweight or obese patients， the recurrence risk is influenced by multiple factors， including diabetes history， polyp number and histological pattern， and the growth site of the largest polyp.

Key words: Colorectal polyp, Recurrence, Influencing factors, Body mass index