The Value Of Follow-up After Colon Cancer And The Factors That Affect Recurrence

Objective: To investigate the clinical significance of postoperative colonoscopy in patients with colon cancer,and to probe the significance of early diagnosis and treatment of postoperative colonoscopy in order to reduce the recurrence rate and improve the survival rate in the future.The clinicopathological characteristics of all patients and the possible factors affecting the postoperative colon cancer were analyzed,and to investigate the prognostic factors of postoperative survival in patients with colon cancer.Methods:The regular colonoscopy was carried out in 445 postoperative colorectal cancer patients(including colonoscopy surgery patients and open surgery patients),including1500 cases of sigmoid colon,130 cases of colon cancer,70 transverse colon,and descending colon cancer 95 cases,biopsy for the doubtful cases and underwent high frequency electricity or argon plasma coagulation treatment for the colon polyps.Colon cancer recurrence and primary tumor pathological type,differentiation and TNM stage is closely related to the recurrence rates were high differentiated adenocarcinoma(14.3%),moderately differentiated adenocarcinoma(18.3%),low differentiated adenocarcinoma(27.9%),papillary adenocarcinoma(4.7%),and mucinous adenocarcinoma(15.3%).I is(9.1%),II is(11.7%),III is(22%),IV is(33.9%).The clinical and pathological data of all patients were collected during hospitalization,including gender,age,primary tumor site,tumor histological type and TNM stage,degree of differentiation,lymph node metastasis and preoperative serum carcinoembryonic antigen(CEA)level.The patients with suspicious lesions were detected by color Doppler ultrasonography and CT examination to determine whether there was recurrence after surgery.The colonic lavage fluid was collected,and the exfoliative cells were detected,and to detect the level of CEA in blood.According to the results of colonoscopy examination,to analyze the influence of age,lymph node metastasis,liver metastasis,tumor location,pathological type of primary tumor and TNM stage on the prognosis and recurrence of colon cancer.Result: There were 40 cases of anastomotic recurrence cancer and 28 cases of multicentric primary carcinoma,45 cases of anastomositis,and 51 cases of adenomatous polyps within two years after surgery,underwent high frequency electricity or argon plasma coagulation treatment for the colon polyps.The follow-up results showed that colon cancer recurrence in postoperative patients with primary cancer patients with gender,age and primary cancer site does not matter much;colon cancer patients preoperative serum level of CEA is higher,the recurrence rate is high,and the amount of the expression level of CEA recurrence in anastomotic carcinoma and multiple primary in the serum of patients with cancer were also significantly increased.The results showed that the level of CEA in blood was significantly enhanced and the shape of the cells was dramatically changed in patients with recurrent.The study indicated that the independent predictors of survival were age,CEA level,tumor general type,lymphatic invasion,liver metastasis,pathological type and TNM stage.The recurrence rate was CEA level greater than 25 ng/ml in 21.5%,CEA level between 5 ~ 25 ng/ml in 16.8%,CEA level less than5ng/ml in 5.7%.Conclusion:1.Postoperative regular follow-up of colon cancer patients is an indispensable link after surgical treatment of colon cancer,is the most effective means of follow-up after radical surgery.2.Through colonoscopy can be directly electrocoagulation resection of colonic polyps,effectively blocking the adenomatous polyps and other precancerous lesions to cancer,reducing the recurrence rate of colon cancer after surgery has a greater clinical value.3.The postoperative recurrence of colon cancer is not correlated with the age,sex and the location of the primary tumor.4.The recurrence of colon cancer is closely related to the pathological type,differentiation degree and tnm stage.the lower the pathological type,the higher the tnm stage and the higher recurrence rate.5.Preoperative serum CEA level and lymph node metastasis in patients with colon cancer is an important factor influencing the recurrence rate and survival rate,among which the higher the CEA level in patients with primary cancer,and the incidence of lymph node metastasis,postoperative recurrence rate significantly increased,so the level of CEA and lymph node metastasis can be used as an important reference for the implementation of clinical treatment program.