Clinical Analysis Of Multiple Primary Colorectal Cancer

[Purpose]To explore the age, sex, morbidity, tumor location, Carcino-Embryonic Antigen(CEA) level, tumor diameter, histopathological type, TNM stage, treatment and prognosis of Multiple Primary Colorectal Cancer(MPCRC), and to provide reference for the diagnosis and treatment of MPCRC in the future , In order to reduce the missed diagnosis rate,improve the treatment effect,and then prolong the survival of patients.[Method]Based on the medical records management system of our hospital, 3838 cases of Colorectal Cancer (CRC) were collected from January 2006 to August 1616.According to the diagnostic criteria of MPCRC proposed by Warran and Gates, the standard cases were screened and the systematic retrospective analysis was carried out.Using regular review and telephone contact for Follow-up, while use the SPSS 21.0 version of the data for statistical analysis.[Result]1 General analysis1.1 Among the 3838 cases of colorectal cancer,a total of 29 cases in line with the standards, and suitable for research, MPCRC incidence rate was 0.75% (29/3838).There were 24 cases of Synchronous Multiple Primary Colorectal Cancer (SCRC) in the same time, the incidence rate was 0.62%;there were only 5 cases of Metachromatous Primary Colorectal Cancer (MCRC) ,and the incidence rate was 0.13%, the incidence of SCRC was significantly higher than MCRC. 29 cases of MPCRC patients aged 58.10 ± 11.87 years old,including 18 males, the age of onset was 56.28 ± 13.34 years; 11 women,the age of onset 61.09 ± 8.14 years,male and female incidence rate was 1.64: 1.1.2 In this study, 26 cases were double cancer, 3 cases were triple cancer, a total of 61 tumor specimens, the ratio of rectal and color disease was 17/44, the rectum, left colon and right colon disease was 17/19/25, the left half of the large intestine and right half was 36/25.1.3 The mean CEA of 29 cases of MPCRC was 9.49 ug / L, of which the mean value of SCRC was 10.75 ug / L and the average value of MCRC was 5.16 ug / L. The average level of CEA both exceeds normal.1.4 There are 21 cases of tumor diameter less than 5cm, and 8 cases greater than or equal to 5cm, the tumor diameter is relatively small.1.5 The study of 95.08% of the pathological type was adenocarcinoma.Adenocarcinoma is mainly manifested as tubular adenocarcinoma, accounting for 81.03%. In addition, 29 cases of MPCRC histological differentiation mainly in the differentiation of the main, of which 69.0% of adenocarcinoma showed moderate differentiation.1.6 Of the 29 patients with MPCRC, there were 27 had radical resection of malignant tumors, and the radical resection rate was above 95%. 26 patients were confirmed by colonoscopy as malignant tumors before surgery,the diagnosis rate of colonoscopy was 90%. 17 patients were followed up for adjuvant chemotherapy, and none of the recurrence or metastasis. 29 cases of MPCRC patients in our hospital most diagnosised in the past two years, and is not suitable for survival analysis.2 Statistical analysis under different positioning2.1 Statistical analysis under general orientation2.1.1 There was no significant difference in the incidence of MPCRC (p = 0.621).2.1.2 There was no significant difference in sex between MPCRC (p = 0.199).2.1.3 There was no significant difference in the age of onset of MPCRC (p =0.069).2.1.4 There was no significant difference in CEA level between MPCRC (p =0.096).2.1.5 There was no significant difference in tumor diameter between MPCRC (p ?0.443).2.1.6 There was no significant difference in the T stage of MPCRC (p = 0.102), but the N staging and TNM staging were statistically significant, p value was 0.048,0.042 respectively.2.2 Statistical Analysis of Different Locations in Split Region2.2.1 There was no significant difference in the incidence of MPCRC (p> 0.05).2.2.2 There was no significant difference in sex between MPCRC (p> 0.05).2.2.3 There was no significant difference in the age of MPCRC (p> 0.05).2.2.4 There was no significant difference in CEA level between MPCRC (p> 0.05).2.2.5 There was no significant difference in tumor diameter between MPCRC (p>0.05).2.2.6 There was no significant difference in the T staging,N staging and TNM staging, all the p value were greater than 0.05.[Conclusion]1 There was no significant difference in the age, sex, morbidity, type of CEA,tumor diameter and tumor diameter of MPCRC(p>0.05). However, when multiple foci were located on the rectum, the N-staging and TNM staging were more likely to occur earlier (p <0.05).2 We should improve the understanding of MPCRC, routine colonoscopy before surgery, while surgery to the colorectal ,we should conduct a comprehensive and careful examination, to improve the detection rate of MPCRC.3 Early diagnosis and standardized treatment, can significantly improve the survival rate of patients, including radical surgery and standardized adjuvant chemotherapy, was beneficial for survival and prognosis of MPCRC patients.4 Colorectal cancer with adenoma or polyps is a risk factor for MPCRC, we must be actively treated to prevent canceration of adenoma or polyps.5 Regardless of staging after surgery of colorectal cancer, we should conduct regular and standardized follow-up and review, in order to improve the diagnosis rate of simultaneous or heterogeneous multiple primary colorectal cancer, so that patients can get early and effective treatment.