胃底腺息肉的影响因素及其与结直肠息肉发生的潜在关系

Exploration of Influencing Factors of Fundic Gland Polyps and Their Potential Relationship with Occurrence of Colorectal Polyps

摘要: 目的：探究胃底腺息肉(FGPs)发生的独立影响因素，并分析其与结直肠息肉(CRPs)发生的潜在关系。方法：采用回顾性病例对照研究，纳入2025年1月至2026年1月于内蒙古自治区人民医院同时行胃镜及肠镜检查的住院患者400例，其中经病理确诊的FGPs患者200例为病例组，同期无FGPs的慢性非萎缩性胃炎患者200例为对照组。收集患者人口学、临床、内镜、病理及实验室检查资料，采用单因素及多因素Logistic回归分析FGPs发生及FGPs患者合并CRPs的影响因素。结果：病例组CRPs检出率显著高于对照组(34.50% vs. 21.00%, P < 0.05)。多因素分析显示，女性(OR = 2.165)、年龄(OR = 1.033)、胆汁反流史(OR = 4.033)、血小板/淋巴细胞比值(PLR) (OR = 1.011)、甘油三酯(OR = 1.673)、糖类抗原199 (CA199) (OR = 1.043)、使用质子泵抑制剂(PPI) (OR = 2.409)、焦虑(OR = 1.986)是FGPs发生的独立危险因素；而幽门螺杆菌(HP)感染史(OR = 0.224)、中性粒细胞绝对值(OR = 0.744)、白蛋白(OR = 0.874)、高密度脂蛋白(OR = 0.206)是其保护因素(均P < 0.05)。在FGPs患者中，非酒精性脂肪肝史(OR = 3.765)、焦虑(OR = 3.212)、女性(OR = 3.132)、甘油三酯(OR = 1.644)及中性粒细胞/淋巴细胞比值(NLR) (OR = 1.758)是合并CRPs的独立危险因素(均P < 0.05)。FGPs合并CRPs的病理类型以腺瘤性息肉和锯齿状病变为主，其中锯齿状病变比例显著高于单纯CRPs患者(P < 0.05)。结论：FGPs的发生与胆汁反流、PPI使用、焦虑及脂代谢紊乱密切相关，而HP感染具有保护作用。FGPs患者是CRPs的高危人群，且倾向于合并锯齿状病变。非酒精性脂肪肝、焦虑、女性及高NLR是FGPs患者发生CRPs的独立危险因素，临床应加强对该类人群的结直肠癌筛查。

Abstract: Objective: To investigate the independent influencing factors for the development of fundic gland polyps (FGPs) and to analyze their potential relationship with the occurrence of Colorectal Polyps (CRPs). Methods: A retrospective case-control study was conducted. A total of 400 inpatients who underwent both gastroscopy and colonoscopy at the Inner Mongolia People’s Hospital from January 2025 to January 2026 were enrolled. The case group comprised 200 patients with pathologically confirmed FGPs, and the control group comprised 200 patients diagnosed with chronic non-atrophic gastritis without FGPs during the same period. Demographic, clinical, endoscopic, pathological, and laboratory data were collected. Univariate and multivariate Logistic regression analyses were performed to identify factors influencing the occurrence of FGPs and the coexistence of FGPs and CRPs. Results: The detection rate of CRPs in the case group was significantly higher than that in the control group (34.50% vs. 21.00%, P < 0.05). Multivariate analysis revealed that female sex (OR = 2.165), age (OR = 1.033), history of bile reflux (OR = 4.033), Platelet-to-Lymphocyte Ratio (PLR) (OR = 1.011), triglycerides (OR = 1.673), Carbohydrate Antigen 199 (CA199) (OR = 1.043), Proton Pump Inhibitor (PPI) use (OR = 2.409), and anxiety (OR = 1.986) were independent risk factors for the development of FGPs, whereas a history of Helicobacter pylori (HP) infection (OR = 0.224), absolute neutrophil count (OR = 0.744), albumin (OR = 0.874), and high-density lipoprotein (OR = 0.206) were protective factors (all P < 0.05). Among patients with FGPs, a history of non-alcoholic fatty liver disease (OR = 3.765), anxiety (OR = 3.212), female sex (OR = 3.132), triglycerides (OR = 1.644), and Neutrophil-to-Lymphocyte Ratio (NLR) (OR = 1.758) were identified as independent risk factors for concurrent CRPs (all P < 0.05). The pathological types of CRPs in patients with FGPs were predominantly adenomatous polyps and serrated lesions, with the proportion of serrated lesions being significantly higher than that in patients with CRPs alone (P < 0.05). Conclusion: The development of FGPs is closely associated with bile reflux, PPI use, anxiety, and lipid metabolism disorders, whereas HP infection exerts a protective effect. Patients with FGPs constitute a high-risk population for CRPs and exhibit a predilection for concurrent serrated lesions. Non-alcoholic fatty liver disease, anxiety, female sex, and elevated NLR are independent risk factors for the occurrence of CRPs in patients with FGPs. Enhanced screening for colorectal cancer should be implemented for this patient population.