Analys The Correlation Of Clinicopathological Characteristics In Colon Cancer With Recurrence And Metastasis

Objective:Through the analysis of clinicopathological characteristics in colon cancer to investigate the clinicopathological factors correlated with postoperative recurrence and metastasis in colon cancer,through the establishment of the relevant factors to improve the early diagnosis of recurrence and metastasis in colon cancer.Methods:Retrospective analysis 215 cases with colon cancer patients confirmed by pathology and have complete data in our hospital from October 2004 to June 2010 by using univariate and multivariate method, the patients were treated and followed up.The 69 cases recurrence and metastasis and the 145 cases without recurrence and metastasis were comparatively analyzed.Univariate analysis is used X2 or Fisher exactly the probability method,then the meaningful options in univariate analysis is used Cox model multivariate analysis, P＜0.05 is statistically significant.Results:The overall recurrence and metastasis rate was 32.1%(65/215),Univariate analysis results show that obstruction,tumor size,Dukes' stage,lymph node metastases,histological differentiation,differentiation rade,carcinoembryonic antigen (CEA)level were associated with tumor recurrence and metastasis(P<0.05).Yet,age,g-ender,symptom duration,postoperative adjuvant chemotherapy, tumor location,gross morphology of tumor,carbohydrate antigen(CA199) level were not associated with tumor recurrence and metastasis(P>0.05).Cox multivariate analysis results show that obstruction,Dukes' stage,lymph node metastases,histological differentiation,differen-tiation grade were associated with tumor recurrence and metastasis(P<0.05).Lymph node metastasis is the most important factor; yet,histological differentiation is the second important factor.Adenocarcinoma and non-adenocarcinoma (including signet-ring cell carcinoma,undifferentiated carcinoma,etc) in recurrence are difference(P<0.05). The recurrence time with one year and after one year in adenocarcinoma was 31.4%(16/51) and 68.6%(35/51);the others was 61.1%(11/18) and 38.9%(7/18).The recurrence and metastasis of Dukes' B stage with chemotherapy and without chemotherapy were 24.7%(20/81) and 28.2%(11/39) (P>0.05);yet,Dukes'C stage were 36.2%(21/58)and 60.9%(14/23) (P＜0.05);The preoperative and postoperative serum levels of CEA in patients with distant viscera metastasis were higher than those patients with anastomotic recurrence and celiac pelvic planting,but histological differentiation in patients with distant viscera metastasis was relatively better.Conclusion:1.obstruction,tumor size,Dukes' stage,lymph node metastases,histologi-cal differentiation,differentiation grade,carcinoembryonic antigen(CEA) level were associated with tumor recurrence and metastasis.2.Obstruction, Dukes stage, lymph node metastasis,histological type and differentiation are independent prognostic factors of recurrence and metastasis.3.poorly differentiated cancer(mucinous adenocarcinoma,signet-ring cell carcinoma,undifferentiated carcinoma)recurrence and metastasis earlier than adenocarcinoma .4.The preoperative and postoperative serum levels of CEA and histological differentiation were closely associated with the location of tumor recurrence and metastasis.