Study On The Clinical Pathology Characteristics And Prognostic Factors Of Stage Ⅱ Colorectal Cancer

Objective:1.To investigate the clinical pathology features and prognostic factors of Stage Ⅱ colorectal cancer.2.To investigate the Distribution characteristics of microsatellite instability and KRAS genes in patients with stage Ⅱ colorectal cancer.3.To investigate whether patients with stage Ⅱ colorectal cancer should undergo adjuvant chemotherapy.Methods:Paraffin specimens of 80 stage Ⅱ colorectal cancer undergoing radical surgery at Wuxi Fourth People’s Hospital between February 2015 and February 2017 were collected.Relevant case data were collected in the clinical record room of our hospital.The expression of the patients’ mismatch repair protein(MLH1,MSH2,MSH6 and PMS2)was detected by immunohistochemistry,and the patients were followed up.All data were analyzed using the SPSS 21.0 statistical software.Results:1.The 3-year disease-free survival rate of the selected study sample was 81.25%,and the overall 3-year survival rate was 88.75%.2.The overall survival of stage Ⅱ colorectal cancer patients is related to whether the patients undergo traditional laparotomy;the disease-free survival is related to four factors:age,tumor volume,preoperative level of carcino embryonic antigen and operation method.3.Disease-free survival is poor if the patient is over 60 years old,with a maximum tumor diameter less than 5cm,and the preoperative levels of CEA are at or above 5ng per ml,undergoing conventional laparotomy.Among them,preoperative CEA level is an independent risk factor affecting patients’disease-free survival.4.The incidence of MSI-H was 21.25%,In the MSI-H group,the preoperative serum CEA level,tumor location,and tumor size were different when compared with the MSS/MSI-L group(P<0.05).In the MSI-H group,tumors were bigger,easy grow in the right hemicolon,and preoperative serum CEA<5ng/ml.5.The mutation rate of the KRAS gene was 43.4%,and the KRAS gene mutation rate was significantly higher in the mucinous adenocarcinoma than in the adenocarcinoma tissue(P<0.05).Conclusion:1.Preoperative CEA>5ng/ml is an independent risk factor for poor prognosis in stage Ⅱ colorectal cancer.2.The different states of MMR have unique clinicopathological features in stage Ⅱ colorectal cancer.In the MSI-H group,the tumor mass volume was larger,right hemicolon accounts for a large proportion,and the serum CEA was less than 5 ng/ml.3.The KRAS mutations and the tissue type of stage Ⅱ colorectal cancer are related.Mutations of the KRAS gene were higher in patients with mucinous adenocarcinoma.