Study On The Relationship Between Serum Homocysteine Level And The Occurrence And Staging Of Rectal Cancer

BackgroundColorectal cancer is the common malignant tumor of digestive tract and we got a high incidence of colorectal cancer.According to the 2017 NCCN guidelines,the incidence of colorectal cancer in the United States in all of the fourth malignant tumors and it has become a significant decline in mortality,and we consider they may have benefited from the United States who pay more attention to the implementation of the early screening and early diagnosis and the development of better treatment.Early screening and early diagnosis are still lacking in China,and we should better improve the effectiveness of the China's medical screening.At present,the main screening methods for colorectal cancer and precancerous lesions include:questionnaire investigations of high risk factors based on digital rectal examination,rectal digital examination,fecal occult blood test,colonoscopy and pathology.Through clinical studies have confirmed that serum homocysteine(Hcy)is widely concerned as a new cancer risk factors,and it has been reported that Hcy has a certain value in the diagnosis of malignant tumors of digestive,respiratory and reproductive endocrine system.Hcy can be used as a serum marker of serum for the early diagnosis,treatment,prognosis and monitoring of the recurrence of tumor.It may have a broad application prospect.However,the correlation between Hcy and rectal cancer has not been reported.So we investigate the correlation between Hcy and the occurrence and development of rectal cancer.The results may provide a preliminary theoretical basis for Hcy as a potential indicator for early screening and diagnosis of rectal cancer.ObjectiveThrough the comparison of the level of serum Hcy in the normal population?patients with rectal polyps and patients with rectal cancer and Hcy level in patients with different pathological staging of rectal cancer,detecting the serum level of Hcy in diagnosis value of rectal cancer and the correlation of Hcy and pathological staging in rectal cancer.Methods313 cases of patients were randomly selected from Qilu Hospital of Shandong University in the Department of Gastroenterology?Department of General Surgery?Department of Oncology,101 cases of rectal polyps and 132 cases of patients with rectal cancer are included.We also randomly selected 80 cases of normal population.According to the electronic colonoscopy and pathological analysis,the subjects were divided into 3 groups:normal group,rectal polypoid lesions,rectal cancer.In addition,according to polyp resection pathology results,according to the definition of high-risk adenoma,patients with benign lesions in intestinal polyps were divided into 2 subgroups:The low risk group(n=84)and high risk group(n=17).According to the surgical records of patients with malignant tumors,and the analysis result of preoperative imaging examination results of pathology after surgery,or according to the American Cancer Association(AJCC)seventh edition staging of malignant lesions in patients with rectal cancer were divided into 4 subgroups:I group(n=28),II group(n=38).? group(n=48)and ? group(n=18).The three groups were divided into 7 subgroups.The serum levels of Hcy were measured by single cycle enzyme assay.All the data were analyzed by SPSS 18.0 software.Results1.Serum Hcy levels were statistically different among the groups:There were significant differences between the normal group and the low risk group of rectal polyps,the high-risk group of rectal polyps,and rectal cancer at various stages(p=0.006?0.017?<0.001?<0.001?<0.001?<0.001);In the 7 subgroup,The low risk group of rectal polyps is not significantly different from rectal polyps at high risk and stage I rectal cancer(p=0.459?0.102);and there was a significant difference between low risk group of rectal polyps and stage ?-? rectal cancer(p=<0.001?<0.001?<0.001);and there was no statistical difference between the high-risk group of rectal polyps and stage I rectal cancer(p=0.592)which was significantly different from stage ?-? rectal cancer(p=0.018?0.001?<0.001);There was a significant difference between stage I rectal cancer and stage ?-? rectal cancer(p=0.035,0.001,0.001),and There was a significant difference between stage ? rectal cancer and stage IV rectal cancer(p=0.017).2.There was a significant correlation between Hcy and the progression of rectal lesions,and the correlation coefficient was 0.49,p<0.001.The correlation between Hcy and the staging of rectal cancer is significant,and the correlation coefficient is 0.186,p=0.006.There was no significant correlation between Hcy and low risk group and high risk group,and the correlation coefficient was 0.094,p=0.386.The correlation between Hcy and rectal cancer was significant,and the correlation coefficient was 0.487,p<0.001.3.Logistic regression analysis showed that.After adjusting for age,sex.tumor markers,and other risk factors,their OR(95%CI)=1.186(1.051-1.338),p=0.006,and the Hcy levels are still significantly associated with the occurrence of rectal cancer,and are superior to other tumor markers.Conclusions1.The level of serum Hcy gradually increased with the progression of rectal lesions.2.The level of serum Hcy is associated with rectal cancer and is independent of age,sex,and other tumor markers;3.The level of serum Hcy has potential potential for early screening,diagnosis and detection of rectal cancer...