Risk factors and clinical prediction models for short-term recurrence after endoscopic surgery in patients with colorectal polyps

Table 1 Demographic characteristics of patients

Variables	Total (n = 362)	Non-relapse group (n = 196)	Relapse group (n = 166)	Statistic	P value
Age, mean ± SD	53.32 ± 9.80	51.83 ± 9.34	55.08 ± 10.07	t = -3.18	0.002
BMI, mean ± SD	24.29 ± 3.17	24.12 ± 3.15	24.49 ± 3.18	t = -1.08	0.280
Sex, n (%)				χ2 = 2.14	0.144
Female	139 (38.40)	82 (41.84)	57 (34.34)
Male	223 (61.60)	114 (58.16)	109 (65.66)
Hypertension, n (%)				χ2 = 0.50	0.478
No	251 (69.34)	139 (70.92)	112 (67.47)
Yes	111 (30.66)	57 (29.08)	54 (32.53)
Diabetes, n (%)				χ2 = 1.10	0.293
No	329 (90.88)	181 (92.35)	148 (89.16)
Yes	33 (9.12)	15 (7.65)	18 (10.84)
Hyperlipidemia, n (%)				χ2 = 1.60	0.205
No	304 (83.98)	169 (86.22)	135 (81.33)
Yes	58 (16.02)	27 (13.78)	31 (18.67)
Family history, n (%)				χ2 = 0.12	0.725
No	280 (77.35)	153 (78.06)	127 (76.51)
Yes	82 (22.65)	43 (21.94)	39 (23.49)
Smoking, n (%)				χ2 = 5.95	0.015
No	308 (85.08)	175 (89.29)	133 (80.12)
Yes	54 (14.92)	21 (10.71)	33 (19.88)
Drinking, n (%)				χ2 = 3.91	0.048
No	289 (79.83)	164 (83.67)	125 (75.30)
Yes	73 (20.17)	32 (16.33)	41 (24.70)

BMI: Body mass index.

Table 2 Differences in clinical characteristics between the two groups, n (%)

Variables	Total (n = 362)	Non-relapse group (n = 196)	Relapse group (n = 166)	Statistic	P value
H. pylori infection				χ2 = 11.15	< 0.001
No	252 (69.61)	151 (77.04)	101 (60.84)
Yes	110 (30.39)	45 (22.96)	65 (39.16)
Gastric polyp				χ2 = 0.19	0.663
No	317 (87.57)	173 (88.27)	144 (86.75)
Yes	45 (12.43)	23 (11.73)	22 (13.25)
Polyp diameter				χ2 = 2.86	0.091
≤ 2 cm	239 (66.02)	137 (69.90)	102 (61.45)
> 2 cm	123 (33.98)	59 (30.10)	64 (38.55)
Polyp number				χ2 = 5.75	0.016
≤ 2	231 (63.81)	136 (69.39)	95 (57.23)
> 2	131 (36.19)	60 (30.61)	71 (42.77)
Polyp location				χ2 = 1.76	0.184
Distal colon	186 (51.38)	107 (54.59)	79 (47.59)
Proximal colon	176 (48.62)	89 (45.41)	87 (52.41)
Polyp color				χ2 = 0.71	0.400
Rubedo	303 (83.70)	167 (85.20)	136 (81.93)
Non-redness	59 (16.30)	29 (14.80)	30 (18.07)
Polyp morphology				χ2 = 5.26	0.022
Pedunculated or subpedunculated	95 (26.24)	61 (31.12)	34 (20.48)
Sessile	267 (73.76)	135 (68.88)	132 (79.52)
Excision mode				χ2 = 0.22	0.638
EMR	281 (77.62)	154 (78.57)	127 (76.51)
Others	81 (22.38)	42 (21.43)	39 (23.49)
Intraoperative bleeding				χ2 = 1.11	0.292
No	327 (90.33)	180 (91.84)	147 (88.55)
Yes	35 (9.67)	16 (8.16)	19 (11.45)
Pathological type				χ2 = 17.29	< 0.001
Others	126 (34.81)	87 (44.39)	39 (23.49)
Adenomatous	236 (65.19)	109 (55.61)	127 (76.51)

H. pylori: Helicobacter pylori; EMR: Endoscopic mucosal resection.

Table 3 Univariate logistic regression analysis

Variables	β	SE	Z	P value	OR (95%CI)
Age	0.03	0.01	3.11	0.002	1.04 (1.01-1.06)
BMI	0.04	0.03	1.08	0.280	1.04 (0.97-1.11)
Sex
Female					1.00 (reference)
Male	0.32	0.22	1.46	0.144	1.38 (0.90-2.11)
Hypertension
No					1.00 (reference)
Yes	0.16	0.23	0.71	0.478	1.18 (0.75-1.84)
Diabetes
No					1.00 (reference)
Yes	0.38	0.37	1.05	0.296	1.47 (0.72-3.01)
Hyperlipidemia
No					1.00 (reference)
Yes	0.36	0.29	1.26	0.207	1.44 (0.82-2.52)
Family history
No					1.00 (reference)
Yes	0.09	0.25	0.35	0.725	1.09 (0.67-1.79)
Smoking
No					1.00 (reference)
Yes	0.73	0.30	2.41	0.016	2.07 (1.14-3.74)
Drinking
No					1.00 (reference)
Yes	0.52	0.26	1.97	0.049	1.68 (1.01-2.82)
H. pylori infection
No					1.00 (reference)
Yes	0.77	0.23	3.31	< 0.001	2.16 (1.37-3.41)
Gastric polyp
No					1.00 (reference)
Yes	0.14	0.32	0.44	0.663	1.15 (0.62-2.15)
Polyp diameter
≤ 2 cm					1.00 (reference)
> 2 cm	0.38	0.22	1.69	0.091	1.46 (0.94-2.26)
Polyp number
≤ 2					1.00 (reference)
> 2	0.53	0.22	2.39	0.017	1.69 (1.10-2.61)
Polyp location
Distal colon					1.00 (reference)
Proximal colon	0.28	0.21	1.33	0.185	1.32 (0.87-2.00)
Polyp color
Rubedo					1.00 (reference)
Non-redness	0.24	0.28	0.84	0.401	1.27 (0.73-2.22)
Polyp morphology
Pedunculated or subpedunculated					1.00 (reference)
Sessile	0.56	0.25	2.28	0.023	1.75 (1.08-2.84)
Excision mode
EMR					1.00 (reference)
Others	0.12	0.25	0.47	0.639	1.13 (0.69-1.85)
Intraoperative bleeding
No					1.00 (reference)
Yes	0.37	0.36	1.05	0.294	1.45 (0.72-2.93)
Pathological type
Others					1.00 (reference)
Adenomatous	0.96	0.23	4.10	< 0.001	2.60 (1.65-4.10)

BMI: Body mass index; H. pylori: Helicobacter pylori; EMR: Endoscopic mucosal resection.

Table 4 Multivariate logistic regression analysis

Variables	β	SE	Z	P value	OR (95%CI)
Age	0.04	0.01	3.09	0.002	1.04 (1.01-1.06)
Drinking
No					1.00 (reference)
Yes	0.73	0.29	2.50	0.012	2.07 (1.17-3.67)
H. pylori infection
No					1.00 (reference)
Yes	0.85	0.25	3.36	< 0.001	2.34 (1.43-3.85)
Polyp number
≤ 2					1.00 (reference)
> 2	0.68	0.24	2.80	0.005	1.98 (1.23-3.19)
Polyp morphology
Pedunculated or subpedunculated					1.00 (reference)
Sessile	0.74	0.27	2.75	0.006	2.10 (1.24-3.57)
Pathological type
Others					1.00 (reference)
Adenomatous	1.10	0.25	4.40	< 0.001	3.02 (1.85-4.94)

H. pylori: Helicobacter pylori.

Table 5 Confusion matrix analysis of prediction models

Accuracy (95%CI)	Sensitivity (95%CI)	Specificity (95%CI)	PPV (95%CI)	NPV (95%CI)	Cut-off
0.69 (0.64-0.74)	0.80 (0.74-0.85)	0.56 (0.48-0.64)	0.68 (0.62-0.74)	0.70 (0.62-0.78)	0.535

PPV: Positive predictive value; NPV: Negative predictive value.