Analysis Of Risk Factors Of Lymphatic Vascular Invasion In Colorectal Cancer And Its Relationship With Prognosis

Purpose:The purpose of this study was to explore the correlation between vascular invasion and clinicopathological features of colorectal cancer and its effect on the prognosis of patients with stage II colorectal cancer,and to explore whether vascular invasion could provide a reference for clinical decision-making,so as to provide more precise "individualized" treatment and improve the prognosis of patients.Methods:1.The clinicopathological data of 1159 patients with colorectal cancer who underwent surgical treatment in Xijing Hospital Affiliated to Air Force Military Medical University from June 2010 to December 2017 were retrospectively collected.All the patients with colorectal cancer were diagnosed by the Department of Pathology of our hospital.All the cancer tissue samples were stained with hematoxylin-eosin and immunohistochemistry.Routine staining and D2-40 immunohistochemistry were used for lymphatic vessel invasion,while routine staining and CD34 immunohistochemistry were used for vascular invasion.Statistical methods were used to analyze the relationship between vascular invasion and clinicopathological features.2.Screening and collating 314 patients with stage II colorectal cancer who underwent radical resection of colorectal cancer in the Department of Gastroenterology,Xijing Hospital Affiliated to Air Force Military Medical University from June 2012 to June 2016 were followed up regularly and closely.The effect of vascular invasion on the prognosis of stage II colorectal cancer patients was analyzed by statistical methods.The results of:1.1 Univariate analysis results showed that there were statistically significant differences between vascular invasion and tumor size,gross type,degree of differentiation,T stage,lymph node metastasis and nerve invasion(P < 0.05),while there were no statistically significant differences between vascular invasion and gender,age and tumor site(P > 0.05).1.2 Logistic multivariate regression showed that the degree of differentiation,lymph node metastasis,nerve invasion were correlated with vascular invasion(P < 0.05).2.Prognostic analysis: There were 314 patients with stage II colorectal cancer in the whole group,including 64 patients in the vascularization group and 250 patients in the non-vascularization group.The median follow-up time was 56(2-100)months.The 5-year survival rate of the whole group was 80.3%,and the 5-year survival rate of the patients with vascular invasion was 62.5%,which was significantly lower than that of the patients without vascular invasion(χ2= 10.815,P = 0.010).Subgroup analysis: Among the 64 patients with positive vascular invasion,42 received postoperative adjuvant chemotherapy,and 22 did not receive postoperative adjuvant chemotherapy.There was no significant difference in survival rate between the two groups(χ2= 0.340,P = 0.560).Univariate survival analysis showed that the 5-year overall survival rate of patients with colorectal cancer was correlated with age,tumor site,tumor diameter,T stage,DMMR,and vascular invasion(P < 0.05),but not with gender,gross type,nerve invasion,and postoperative adjuvant chemotherapy(P > 0.05).Multivariate survival analysis showed that the 5-year overall survival rate of patients with CRC was correlated with age,DMMR and vascular invasion(P < 0.05).Conclusion:1.Vascular invasion in colorectal cancer is closely related to pathological low differentiation,positive lymph node metastasis and positive nerve invasion.2.Colorectal cancer vessel invasion is an independent risk factor for 5-year overall survival in patients with stage II colorectal cancer,suggesting a poor prognosis.However,adjuvant chemotherapy did not show significant survival benefit in patients with positive vessel invasion.Therefore,the predictive effect of vascular invasion on the directivity of postoperative adjuvant therapy needs further studies to prove.