Polarization Of Intestinal Tumor-associated Macrophages Regulate The Occurrence And Development Of Schistosomal Colorectal Cancer

Objective: The aim of this study is to investigate the correlation between Schistosomiasis japonica and Colorectal Cancer(CRC).Pathological experiments were used to analyze the effect of intestinal tumor-associated macrophages(TAMs)on the occurrence and development of schistosomal CRC.Methods: 1.The clinical and pathological data of 265 patients with schistosomal CRC and 3289 patients with nonschistosomal CRC admitted in the First Affiliated Hospital of Wannan Medical College from January 2012 to December 2018 were retrospectively analyzed and Logistic regression analysis.2.Telephone follow-up was performed on 43 schistosomal CRC and 57 nonschistosomal CRC patients obtained by stratified sampling to obtain patients data and conduct survival analysis.3.According to the distribution of age and degree of differentiation,stratified sampling was carried out.Ten patients were selected from patients with schistosomal CRC and nonschistosomal CRC to conduct pathological experiments,which were divided into schistosomiasis group and nonschistosomiasis group;Ten patients were randomly selected from schistosomal CRC and nonschistosomal CRC.They were divided into schistosomiasis distant lymph node metastasis group and no lymph node distant metastasis group.Pathological experiments were carried out in the lymph node distant metastasis group.4.At the same time,10 cases of schistosomiasis combined with enteritis and schistosomiasis combined with colorectal adenoma in the same period of the First Affiliated Hospital of Wannan Medical College were collected and divided into schistosomiasis enteritis group and schistosomiasis adenoma group.5.Use relevant statistical software for statistical analysis of the pathological results.Results: 1.Normal information Retrospective analysis of 3289 patients with nonschistosomal CRC and 265 patients with schistosomal CRC found that the average age of patients with schistosomal CRC was significantly higher than that of patients with nonschistosomal CRC(P <0.05).In terms of gender distribution,there were more male than female in both groups,but the ratio of male to female in the schistosomal group was higher than that in the nonschistosomal group(P=0.001).The two groups were mostly ulcerative,but the proportion of infiltrating types in the schistosomal group was more than that in the nonschistosomal group,with statistical differences(P=0.003).Fecal occult blood positive also differs(P=0.002).In the TNM stage,the proportion of patients with schistosomiasis T1-3 stage was lower than that of nonschistosomiasis,but the proportion of T4 stage in schistosomiasis was significantly higher than that of nonschistosomiasis,which was statistically different(P=0.001).There were no statistical differences between the two groups of patients in terms of tumor location,degree of differentiation,pathological classification,pathological N stage and pathological M stage(P>0.05).Including the above results in a logistic regression analysis model,the results showed that age(P=0.003),gender(P=0.002),pathological T stage(P=0.005),and combined schistosomiasis(P=0.029)were independent risk factors for CRC.Analysis of the collected data of follow-up patients,the results showed that the average age of death of patients with schistosomal CRC was 62.43 ± 3.15,which was lower than 66.35 ± 1.96 of nonschistosomal CRC patients,which was statistically different(P=0.004).The 5-year survival rate of patients with schistosomal CRC was 46.40%,which was significantly lower than 68.90% of nonschistosomal CRC,which was statistically different(P=0.015).2.Experimental results of histopathology After the diagnosis of H&E staining,immunohistochemical staining was performed on the tissue sections,and the results were counted.The results showed that the number of macrophages in schistosomal CRC tissues was much higher than that in nonschistosomal tissues,especially M2-type macrophages,that is,TAMs,with statistical differences(P<0.05).In the process of schistosomal CRC,the number of macrophages is increasing,especially the proportion of M2 macrophages in each stage.However,macrophages are the most abundant in Colorectitis tissue,and most of them are M1-type macrophages.During the malignant process of CRC,the number of macrophages also increased significantly.The number of TAMs in patients with distant lymph node metastasis was significantly higher than that in patients without distant lymph node metastasis,which was statistically different(P<0.05).Conclusions: Schistosomiasis may promote the polarization of intestinal TAMs to M2 TAMs and affect the development and prognosis of CRC,leading to differences in the clinicopathological characteristics and prognostic survival time of schistosomal and nonschistosomal CRC patients.Logistic regression analysis results prove that schistosomiasis is an independent risk factor for CRC.The number of M2 TAMs in the tissues of patients with schistosomal CRC is much higher than that of patients with nonschistosomal CRC,and M2 TAMs play a role in the malignant process of schistosomal colorectal tissue.Schistosoma may promote the development of colorectal cancer by affecting the polarization of TAMs to M2 type.