| ObjectiveTo study the clinicopathological data of colorectal cancer patients and the risk factors of lymph node metastasis,analyze the clinicopathological characteristics of age groups,and provide effective data for the screening,diagnosis,treatment and prognosis of colorectal cancer patients.MethodsMedical records of 414 patients diagnosed with colorectal cancer by endoscopic or surgical biopsy during hospitalization from January 2018 to December 2019 were obtained from the Lanzhou University First Hospital,analysis of the basic information,clinical performance,part of the laboratory indicators,306 cases have complete pathological data,analysis of the pathological biopsy results and surgical treatment,Groups were compared with statistical differences in clinicopathological characteristics by age,patients with lymph node metastasis were further analyzed by Logistic regression.Results1.the epidemiological and clinical characteristics of 414 patients included in this study were mainly male onset.The highest incidence rate was 60-79 years old,and Han nationality was the main ethnic group.Most of the patients（43.2%）came from Lanzhou and the county seat.The onset of the rectum（54.6%）is the most common site,the right colon common than the left colon,the ascending colon and the sigmoid colon is common in right colon and left colon respectively.The first symptoms were blood stool（35.6%）,followed by abdominal pain and distension（32.4%）and changes in defecation habits（20.8%）.Distant metastases were common with liver metastases（48cases）.Moderately differentiated adenocarcinoma（46.9%）was the most common.306 cases had complete surgical pathology.The tumor diameter ≤ 5cm（56.9%）was the most common.The general type was mainly ulcerative（58.2%）,34.0% patients had intravascular cancer thrombus,40.8% had lymphatic cancer thrombus,34.0% had nerve invasion.The depth of invasion was mainly T3+T4.p TNM stage was the most common with stageⅢ,and the operation method was laparoscopy（52.6%）.2.according to age group analysis,the incidence rate of male in three groups was higher than that in females,and the incidence increased in men with age.Rectal incidence was the most common in the three groups,left colon is common in under the age of 50 and the right colon over the age of 75.There was no significant difference in gender and location among the three groups.Among the three groups,the family history of gastrointestinal diseases was the most common under the age of 50,first symptom hematochezia and changes in defecation habits were common between the ages of 50 and 74,platelet was mainly elevated in patients under the age of 50,while elevated fasting blood-glucose and decreased albumin were common in patients over 75 years of age.Hypertension,diabetes or more than 2 accompanying diseases are common among patients over 75 years old.Abdominal pelvic metastasis is common in patients under 50 years old,and the above differences are statistically significant（P < 0.05）.The degree of differentiation is common with low differentiation in patients under 50 years,and 50-74 and ≥ 75 years were common with medium differentiation,but the difference was not statistically significant（P > 0.05）.Infiltration depth T1 + T2 is common in patients aged 50-74 years,followed by those aged below 50 years,T3 + T4 is common in patients aged above 75 years,followed by those aged below 50 years.The proportion of stage IV in cases under 50 years was higher than that in the remaining two groups,laparoscopic surgery is mainly in patients aged below 50 years,and open surgery in aged above 75 years.There are significant differences in infiltration depth,p TNM stage and operation methods among the three groups（P < 0.05）.3.In the risk factor analysis of lymph node metastasis,univariate analysis showed that lymph node metastasis was related to gross type,degree of differentiation,intravascular tumor thrombus,nerve invasion,depth of invasion,CEA,CA199,etc.multivariate analysis showed that depth of invasion was an independent risk factor of lymph node metastasis.ConclusionThe most common site of colorectal cancer is rectum.The first symptoms are hematochezia,abdominal pain distension and changes in defecation habits.The metastasis is liver metastasis,the degree of differentiation is medium differentiation,p TNM stage is stage Ⅲ,and laparoscopy is common.Cases under the age of 50 often have family history of gastrointestinal diseases,high platelet,low degree of tumor differentiation,high rate of vascular invasion and lymph node metastasis,deep depth of invasion and other characteristics,while cases over the age of 75 rarely have relevant family history,many accompanying diseases,low degree of tumor differentiation,high rate of vascular invasion,high invasiveness and low rate of lymph node metastasis.Cases aged 50-74 years have a high degree of differentiation and low invasiveness,and the rest characteristics are between the other two groups.The depth of invasion is an independent risk factor for lymph node metastasis. |
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