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Background <p>Colorectal laterally spreading tumors (LSTs) are precancerous lesions with potential for malignant transformation. The coexistence of LSTs with colorectal polyps may indicate increased risk for early colorectal cancer, yet the associated clinicopathological risk factors remain poorly defined.</p> Methods <p>This retrospective study included 229 patients diagnosed with LSTs from January 2020 to March 2024 at a single center. Patients were divided into the polyp group (<i>n</i> = 139) and the non-polyp group (<i>n</i> = 90) based on the coexistence of colorectal polyps. The polyp group was further subdivided into malignant group (<i>n</i> = 62) and non-malignant group (<i>n</i> = 77). Clinicopathological characteristics were compared, and binary logistic regression was used to identify predictive factors for coexistence and for malignancy in LSTs with colorectal polyps.</p> Results <p>Female (OR = 0.330, 95%CI: 0.186–0.586; <i>P</i> &lt; 0.001) was associated with a decreased risk, while age &gt; 75 years (OR = 4.293, 95%CI: 1.060–17.376; <i>P</i> = 0.041) was associated with an increased risk for the coexistence of colorectal polyps with LSTs. The area under the receiver operating characteristic curve (AUC) for the predictive model was 0.703 (95%CI 0.633–0.773; <i>P</i> &lt; 0.001). LSTs diameter ≥ 2&#xa0;cm (OR = 4.574, 95%CI: 1.754–11.933; <i>P</i> = 0.002) and G-M morphological type (were associated with increased risk, while NG-FE morphological type (OR = 0.182, 95%CI: 0.039–0.845; <i>P</i> = 0.030) was associated with decreased risk for malignancy in LSTs coexisting with colorectal polyps. The AUC for this predictive model was 0.873 (95%CI: 2.788–27.530; <i>P</i> &lt; 0.001).</p> Conclusion <p>Males and individuals &gt; 75 years may be at higher risk of LSTs coexisting with colorectal polyps. LST diameter ≥ 2&#xa0;cm and the G-M morphological type are potential independent risk factors for malignant transformation, though further validation is needed. These results emphasize the necessity of endoscopic screening and early intervention for males, those older than 75 years, with LST dimeter ≥ 2&#xa0;cm, and with the G-M morphological type.</p> Clinical trials <p>Not applicable.</p>

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Predictive factors for the coexistence of colorectal lateral spreading tumors and colorectal polyps, and risk factors for malignancy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月14日

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  • Qingwen Yuan,
  • Jiafu Song,
  • Zhimei Zhang,
  • Shuxian Zhang,
  • Xuyang Liang

摘要

Background

Colorectal laterally spreading tumors (LSTs) are precancerous lesions with potential for malignant transformation. The coexistence of LSTs with colorectal polyps may indicate increased risk for early colorectal cancer, yet the associated clinicopathological risk factors remain poorly defined.

Methods

This retrospective study included 229 patients diagnosed with LSTs from January 2020 to March 2024 at a single center. Patients were divided into the polyp group (n = 139) and the non-polyp group (n = 90) based on the coexistence of colorectal polyps. The polyp group was further subdivided into malignant group (n = 62) and non-malignant group (n = 77). Clinicopathological characteristics were compared, and binary logistic regression was used to identify predictive factors for coexistence and for malignancy in LSTs with colorectal polyps.

Results

Female (OR = 0.330, 95%CI: 0.186–0.586; P < 0.001) was associated with a decreased risk, while age > 75 years (OR = 4.293, 95%CI: 1.060–17.376; P = 0.041) was associated with an increased risk for the coexistence of colorectal polyps with LSTs. The area under the receiver operating characteristic curve (AUC) for the predictive model was 0.703 (95%CI 0.633–0.773; P < 0.001). LSTs diameter ≥ 2 cm (OR = 4.574, 95%CI: 1.754–11.933; P = 0.002) and G-M morphological type (were associated with increased risk, while NG-FE morphological type (OR = 0.182, 95%CI: 0.039–0.845; P = 0.030) was associated with decreased risk for malignancy in LSTs coexisting with colorectal polyps. The AUC for this predictive model was 0.873 (95%CI: 2.788–27.530; P < 0.001).

Conclusion

Males and individuals > 75 years may be at higher risk of LSTs coexisting with colorectal polyps. LST diameter ≥ 2 cm and the G-M morphological type are potential independent risk factors for malignant transformation, though further validation is needed. These results emphasize the necessity of endoscopic screening and early intervention for males, those older than 75 years, with LST dimeter ≥ 2 cm, and with the G-M morphological type.

Clinical trials

Not applicable.