Risk Analysis Of Lymphatic Metastasis And Differential Analysis Of Biopsy And Postoperative Pathological Diagnosis In Early Colorectal Cancer

Background and aims:Early colorectal cancer is defined as any size invasive adenocarcinoma invading into,but not beyond,the submucosa,with or without lymph node metastasis.It is critical that the risk of lymph node metastasis(LNM)is evaluated for determining the suitability of endoscopic resection for early colorectal cancer(ECC).At present,there is still no consensus on the risk factors associated with lymph node metastasis in early colorectal cancer at domestic and overseas,and the answer of question “ is it the same of early colorectal biopsy forceps biopsy and postoperative pathological findings?”is not clear.The purpose of this study was to investigate the correlation between clinicopathological features and lymph node metastasis in early colorectal cancer and to explore the difference between early colorectal biopsy and postoperative pathological diagnosis.Methods:Risk analysis of lymphatic metastasis in early colorectal cancer:This study collected data on clinical and pathological features of subjects diagnosed with early colorectal cancer who underwent surgical treatment of colorectal cancer after general surgery in our department from January 2007 to January 2017.In order to evaluate risk factors of LNM in ECC patients,we included gender,history of drinking,history of previous polyps,history of previous colorectal cancer,age,serum tumor makers,tumor phenotype,tumor size,location,lymphatic vessel invasion,differentiation,tumor sprouting etc 12 clinical and pathological indicators.X2 test and logistic regression analysis were used to analyze the relationship between different clinicopathological characteristics and lymph node metastasis of early colorectal cancer and the risk factors of lymph node metastasis in early colorectal cancer.differential analysis of biopsy and postoperative pathological diagnosis in early colorectal cancer:We collected patients who underwent preoperative colonoscopic biopsy and colorectal cancer surgery which the final pathological findings were confirmed as early colorectal cancer in our department from January 2007 to January2017 as the study object.Paired sample Wilcoxon rank test was used to analyze thedifference between early colorectal biopsy and postoperative pathological diagnosis.Results:(1)In the study of correlation between clinicopathological features and lymph node metastasis of early colorectal cancer ultimately included 189 patients with early colorectal cancer who underwent colorectal cancer surgery in our department from January 2007 to January 2017.There were 22 cases of lymph node metastasis,and the total lymph node metastasis rate was 11.6%(22/189).According to the univariate X2 test results,the degree of tumor differentiation,vascular tumor embolus,and tumor budding(X2 values: 0.002,<0.001,<0.001)were associated with lymph node metastasis of early colorectal cancer.Multivariate logistic regression analysis showed that Vascular tumor thrombus and tumor budding were independent risk factors for lymph node metastasis of early colorectal cancer(OR values were8.263 and 1.132,respectively;P was less than 0.05).(2)In the study of differences between biopsy and postoperative pathological diagnosis ultimately included 152 patients,the result shows that early colorectal biopsy forceps biopsy and intraoperative total resection pathological results have significant differences.(Z=-7.762,P=0.000)Conclusion:(1)The independent risk factors for early lymph node metastasis of colorectal cancer were angiolymphatic invasion and tumor budding,and the OR value of angiolymphatic invasion was the highest.(2)In poorly differentiated ECC patients,strict endoscopic follow-up is needed to prevent recurrence of early cancer.Once there is a vascular tumor thrombus and tumor budding,it needs additional surgical treatment and lymph node dissection.(3)Clinically,a comprehensive assessment is required when the pathological findings of a colonoscopy biopsy are suspected malignant lesions to ensure that the patient is given the best treatment plan.