Retrospective Study On The Risk Factors Of Right Colon Cancer With Anemia

Objective: To investigate the risk factors of cancer related anemia in patients with right colon cancer by retrospective study and make people pay more attention to the prevention and treatment of anemia.Method: Clinical materials of 224 patients with right colon cancer are analysed retrospectively.The data include the patient's age,gender,position,TNM staging,specific treatment,related blood routine test and liver function test,and so on.These are established into appropriate information database.Positive standards are in accordance with the eighth edition < diagnostics > of definition of anemia and the National Cancer Institute classification standard of anemia.Statistical analysis is performed with the SPSS 19.0 statistical software.The count data are described by frequency,the relationship between the clinical materials and the incidence of anemia are analyzed by ?2test.Using Rank sum test analyzes age and position of anemia grade and using Logistic regression explores the risk factors associated with anemia,P<0.05 as statistically significant test standard.Result:224 qualified cases,the results were as follows.1 There are 74 cases of patients with non-anemia,accounting 33.04% of the total.There are 56 cases of patients with grade one anemia,63 cases of patients with grade two anemia,24 cases of patients with grade three anemia and 7cases of patients with grade four anemia,respectively,accounting for 25.00%,28.13%,10.71% and 3.12%.Among the patients with anemia,there are73 cases of patients with normocytic anemia,43 patients with hypochromic microcytic anemia,33 patients with simple small cell anemia and only 1patient with macrocytic anemia,respectively,accounting for 32.60%,19.26%,14.70% and 0.40%.Right colon cancer patients prone to grade one and grade two anemia.Among the patients with anemia,it is more common of normocytic anemia and hypochromic microcytic anemia.2 Univariate analysis of the relationship between the occurrence of anemia and2 Univariate analysis of the relationship between the occurrence of anemia and clinical data2.1 The incidence of anemia in patients with different gender(?2=6.201,P=0.013<0.05)is statistically significant.In the right colon cancer patients,the female prone to anemia.2.2 There is no significant difference in the incidence of anemia among different age groups(?2=0.298,P=0.862>0.05).However,there is asignificant difference in anemia grade among different age groups(H= 94.594,P=0.000<0.05)anemia tendencies.Anemia in elderly patients prone to grade three and four anemia.2.3 There is no significant difference in the occurrence of anemia among a variety of locations(?2=4.927,P=0.085>0.05).However,there are statistically significant differences in the levels of anemia in each location(H=37.942,P=0.000<0.05).Ascending colon carcinoma patients prone to grade three and four anemia.2.4 The incidence of anemia in right colon cancer patients with different TNM stages has statistical significance(?2=9.028,P=0.011< 0.05).The later the TNM stage of right colon cancer patients,the higher the incidence of anemia.2.5 It has a significant difference in the size of tumor and the incidence of right colon cancer with anemia(?2=8.8519,P =0.003 <0.05).The larger the size of tumor,the higher the incidence of anemia.2.6 There is a significant difference in albumin level and the incidence of anemia(?2=18.346,P=0.000<0.05).The incidence of anemia is higher in patients with hypoproteinemia.2.7 The patient's gross type(?2=0.075,P=0.963>0.05),differentiated degree(?2=0.017,P=0.896>0.05),pathological type(?2=2.364,P=0.307>0.05),blood vessel invasion(?2=0.261,P=0.610>0.05)and neoplastic intestinal obstruction(?2=1.376,P=0.241>0.05)do not influence the incidence of anemia.2.8 The patient's family history of cancer(?2=0.617,P=0.432>0.05),hyper-tensive disease(?2=0.003,P=0.957>0.05),diabetes(?2=0.135,P=0.714>0.05),drinking history(?2=0.322,P=0.570>0.05),and smoking history(?2=2.333,P=0.127>0.05)do not influence the incidence of anemia.2.9 In this study,60 patients identified KRAS gene status.There is no significant difference in the status of KRAS gene and the incidence of anemia(?2=0.041,P=0.839>0.05).25 patients were examined for MMR status.There is also no significant difference in the status of MMR and the incidence of anemia(?2=0.468,P=0.494>0.05).3 Single factor analysis of the relationship between anemia incidence and treatment of right colon cancer3.1 Radical surgery influence the incidence of anemia(?2=23.783,P=0.000<0.05).The incidence of anemia decreases in patients with right colon cancer after radical surgery.3.2 Chemotherapy influence the incidence of anemia(?2=4.420,P=0.036<0.05).The incidence of anemia increased in patients with right colon cancer after chemotherapy.3.3 The palliative operation(?2=3.775,P=0.052>0.052)and symptomatic treatment(?2=1.164,P=0.281>0.05)have no effects on the influence of anemia.4 Multivariate analysis risk factors for anemia in patients with right colon cancer Hypoproteinemia(P=0.000 < 0.05)and tumor size(P=0.001 < 0.05)are risk factors for anemia.Conclusions:1 Right colon cancer patients prone to grade one and grade two anemia.Among the patients with anemia,it is more common of normocytic anemia and hypochromic microcytic anemia.2 Single factor statistical analysis:the right colon cancer patients with women,later TNM stage,larger the size of tumor,hypoproteinemia and chemotherapy have the higher incidence of anemia.The incidence of anemia decreases in patients with right colon cancer after radical surgery.The patient's gross type,differentiated degree,pathological type,blood vessel invasion,neoplastic intestinal obstruction,family history of cancer,hypertensive disease,diabetes,drinking history,and smoking history are not associated with anemia's incidence.3 There is no significant difference in the incidence of anemia among different age groups and a variety of locations.But if the right colon cancer patients have anemia,elderly patients and ascending colon carcinoma patients prone to grade three and four anemia.4 After a multivariate statistical analysis: we find that hypoproteinemia and tumor size are risk factors for anemia.