P2224 - Predictors of Colorectal Carcinoma in Patients With Colonic Wall Thickening

Ioannis Pothoulakis, MD¹, Colin Wikholm, BS², Vipin Verma, MD³, Akram I. Ahmad, MBBS⁴, Harshkumar Patel, MBBS⁵, Shiva Shankar Vangimalla, MD⁶, Jae Hak Oh, BS², Alex T. Zhao, MS, BS⁷, Kyle Gress, BS², John Bovill, BS², Nikita Deshpande, BS², Maria Marquez, BS², Brynley Dean, BA, BSN, RN², Dwight A. Gholson, BS⁶, Claire Caplan, MS, BA⁸, Loveleen Bhogal, MBBS⁶, Faith E. Buchanan, MD⁹, Won Cho, MD^6
1MedStar Washington Hospital Center, Washington, DC; ²Georgetown University School of Medicine, Washington, DC; ³MedStar Georgetown University Hospital/Washington Hospital Center, Washington, DC; ⁴Medstar Washington Hospital Center, Washington, DC; ⁵Georgetown University, MedStar Health Washington Hospital Center, Washington, DC; ⁶MedStar Washington Hospital Cetner, Washington, DC; ⁷Georgetown University School of Medicine, Raleigh, NC; ⁸Georgetown University School of Medicine, McLean, VA; ⁹Georgetown University, MedStar Washington Hospital Center, Washington, DC

Introduction: Colonic wall thickening (CWT) is a common incidental finding on abdominal computed tomography (CT). Previous data has suggested a significant prevalence of colorectal cancer (CRC) in subjects with CWT, but predictors of CRC in those patients remain unclear. The aim of this study was to identify clinical factors associated with and predictive of colorectal cancer in subjects with CWT.

Methods: Subjects with an abnormal abdominal CT and a follow-up colonoscopy between 2010-2020 were retrospectively reviewed. Patients with CWT in the CT were included in this study. Subjects with age < 18 or pre-existing gastrointestinal malignancy were excluded from this study. Focal CWT was defined as CWT that was localized and present in only one site. Pearson chi-square test and Mann-Whitney U test were used to compare categorical and continuous variables, respectively. A multivariable logistic regression model was performed to assess for factors independently associated with colorectal carcinoma in CWT subjects. Receiver operating characteristic (ROC) curve analysis was used to examine significant parameters in multivariable analysis. Area under the curve (AUC) > 0.7 was used for significant predictive value.

Results: Overall, 1184 patients with abnormal abdominal CT underwent a colonoscopy with biopsy and 269 subjects (23%) with CWT on abdominal CT were identified and included in the analysis. In total, 36 subjects (13%) were found to have CRC on pathology. Distinct characteristics for patients with CRC included older age (68 vs 56; p< 0.05), lower hematocrit (29 vs 36; p< 0.05), higher platelet count (340 vs 249; p< 0.05), lower albumin (2.8 vs 3.3; p< 0.05), and more frequent focal CWT (92 vs 72%; p< 0.05) compared to those without CRC. No significant differences were found in terms of gender, race, BMI, tobacco use, BUN, AST, and ALT levels (all p >0.05). Based on the multivariable logistic regression, low hematocrit (OR 0.86; CI 0.80-0.92), elevated platelets (OR 1.003; CI 1.001-1.005), and focal CWT (OR 4.31; CI 1.06-17.59) were independently associated with CRC in subjects with CWT (all p< 0.05). In ROC curve analysis of the independent variables, AUC for hematocrit, platelets, and focal CWT was 0.773, 0.732, and 0.600 respectively.

Discussion: Based on this study, low hematocrit, elevated platelets, and focal CWT were independently associated with CRC in patients with CWT. In addition, low hematocrit and elevated platelets could potentially be used as predictors of CRC in these subjects.




Disclosures:


Ioannis Pothoulakis, MD¹, Colin Wikholm, BS², Vipin Verma, MD³, Akram I. Ahmad, MBBS⁴, Harshkumar Patel, MBBS⁵, Shiva Shankar Vangimalla, MD⁶, Jae Hak Oh, BS², Alex T. Zhao, MS, BS⁷, Kyle Gress, BS², John Bovill, BS², Nikita Deshpande, BS², Maria Marquez, BS², Brynley Dean, BA, BSN, RN², Dwight A. Gholson, BS⁶, Claire Caplan, MS, BA⁸, Loveleen Bhogal, MBBS⁶, Faith E. Buchanan, MD⁹, Won Cho, MD⁶. P2224 - Predictors of Colorectal Carcinoma in Patients With Colonic Wall Thickening, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.