Chronic Schistosomiasis Promotes The Occurrence Of Colorectal Cancer Provided Epidemiological,Clinical And Histopathologic Proofs

Objective: The aim of this study is to investigate the characteristics between colorectal cancer(CRC)patients with Schistosomiasis and without Schistosomiasis.Methods: The characteristics between CRC patients with and without Schistosomiasis are proved by three strands of evidence derived from epidemiological,clinical and experimental studies.The epidemiological data of Schistosomiasis are provided by Wuhu Center for Schistosome Prevention and Control.The prevalence rate(PR)of Schistosomiasis in Wuhu from 2010 to 2016 is analyzed by statistically methods.The epidemiological data of CRC are provided by Wuhu Center for Disease Control and Prevention(Wuhu CDC).In this study,clinical data are obtained from patients who under radical resection at The First Affiliated Hospital of Wannan Medical Collage(Yijishan Hospital,Wuhu,P.R.China)from 2012 to 2016.22 colonitis patients with Schistosoma infection(Colonitis-S.jap)and 21 colonitis patients without Schistosoma infection(Colonitis-NS.jap)are included as control groups.Results: The prevalence of Schistosomiasis decreased from 5367.95/105 to 1227.47/105 in Wuhu PR.China from 2010 to 2016.The incidence of CRC significantly increased from 23.55/105 to 32.38/105 in Wuhu from 2011 to 2015.The morbidity of CRC in transmission control districts was the highest at age from 61 to 70;it was approximately 10 years earlier than those of transmission interruption districts.In tumor node metastasis(TNM),the proportions of T1-2 in CRC patients with Schistosomiasis were significantly higher than those in patients without Schistosomiasis,and the proportions of T4 were significantly lower than those in patients without Schistosomiasis.The mean numbers of macrophage in patients with Schistosomiasis were significantly more than those in patients without Schistosomiasis.The number of macrophages significantly decreased from inflammation to tumor.In contrast,the percentages of M2 macrophages in CRC patients were significantly increased than those in colonitis patients.With the progression of tumor,the value of M2/M1 ratio had no significantly differences between patients with and without Schistosomiasis.Conclusions: Chronic Schistosomiasis has significantly promoted the occurrence of CRC,and chronic Schistosomiasis mainly promoted the early progression of CRC.Macrophages polarization has played a pivotal role in the development of CRC.Chronic Schistosomiasis preferentially induce the macrophages differentiate to M2 macrophages.Colonoscopy is important in the early detection and treatment of CRC in patients with chronic Schistosomiasis.Screening for CRC in individuals with chronic Schistosomiasis is at least 10 years earlier than in individuals without chronic Schistosomiasis.