Characteristics of colorectal polyps in patients with melanosis coli and construction of predictive model for recurrence after polypectomy
- VernacularTitle:大肠黑变病患者大肠息肉特征分析及息肉切除后复发预测模型构建
- Author:
Kui DONG
1
;
Jie WU
;
Jing YAN
;
Jun WANG
;
Guan'en QIAO
Author Information
- Keywords: melanosis coli; colorectal polyps; recurrence; prediction model; dysplasia; He-licobacter pylori infection; cholecystectomy; influencing factors
- From: Journal of Clinical Medicine in Practice 2025;29(13):72-78
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the clinical characteristics of colorectal polyps in patients with melanosis coli(MC),analyze the recurrence risk after polypectomy,and construct a prediction model for polyp recurrence.Methods A total of 1,763 patients who underwent colorectal polypec-tomy at the First Hospital of Handan from January 2017 to June 2023 were divided into MC group(n=149)and non-MC group(n=1,614).Among them,122 patients in the MC group underwent colonoscopic re-examination one year later and were further divided into recurrence group(n=52)and non-recurrence group(n=70)based on polyp recurrence.The characteristics of colorectal polyps and recurrence risk after polypectomy in MC patients were analyzed.A multivariable Logistic regression analysis was used to construct a polyp recurrence risk model,and the nomogram model was plotted using R studio software.The receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis were employed to evaluate the discrimination,calibration,and clinical practicality of the model.Results The detection rates of large polyps(≥1.0 cm),right-sided colon polyps,multiple polyps(≥3 polyps),and Yamada type Ⅰ polyps in the MC group were significantly higher than those in the non-MC group,while the detection rates of left-sided co-lon polyps and Yamada type Ⅳ polyps were significantly lower(P＜0.05).The detection rates of adenomatous polyps and polyps with mild dysplasia in the MC group were significantly higher than those in the non-MC group,whereas the detection rate of polyps with moderate dysplasia in the MC group was significantly lower(P＜0.05).Significant differences were observed between the recur-rence and non-recurrence groups in terms of a history of cholecystectomy,Helicobacter pylori(Hp)in-fection,and family history of colorectal cancer(P＜0.05).There were also significant differences in the distribution,size,and the number of initial polyps between the two groups(P＜0.05).Multivari-able Logistic regression analysis identified cholecystectomy,Hp infection,first-degree relatives with colorectal cancer,polyp size(≥1 cm),and multiple polyps(≥3 polyps)as independent risk factors for polyp recurrence after polypectomy(P＜0.05).Based on these factors,a recurrence prediction model was constructed.The area under the curve(AUC)of this model was 0.824(95％CI,0.753 to 0.895),indicating good discrimination.The calibration curve showed a good fit.Decision curve anal-ysis demonstrated a high net benefit within the threshold range of 0.1 to 0.8,suggesting that the mod-el had a wide range of beneficial thresholds and clinical practical value.Conclusion Compared with the non-MC group,the MC group has higher detection rates of large polyps,right-sided colon pol-yps,multiple polyps,Yamada type Ⅰ polyps,adenomatous polyps,and polyps with low-grade dys-plasia,but lower detection rates of left-sided colon polyps,Yamada type Ⅳ polyps,and polyps with moderate dysplasia.Cholecystectomy,Hp infection,first-degree relatives with colorectal cancer,large polyps(≥1 cm),and multiple polyps(≥3 polyps)are independent risk factors for polyp re-currence after colorectal polypectomy in MC patients.The recurrence prediction model constructed based on these factors has high practical value.
