| Background and ObjectiveRecently the rate of anemia of colorectal cancer is high,It's controversial about the impact of anemia on the prognosis of colorectal.carcinoembryonic antigen(CEA)has a relational to the diameter and afford of tumor.It's more likely to cause the rupture of tumor when the diameter of tumor is bigger,which leads to the occurrence or worse of anemia.The aim of the study is to explore the relationship between the anemia and prognosis of colorectal cancer and the cause of anemia by the survival of the CEA-negative-patient in Guangzhou No.1 People's Hospital and the level of preoperative Hb(hemoglobin),hope to make a reference on the prognosis of colorectal cancer,at the same time,to promote the individualized and standardized treatment of colorectal cancer patients.Method1.Select the preoperative the level of CEA in serum less than 5ug/L colorectal cancer patients 148 with postoperative pathologically confirmed from 1 Jan,2014 to 31 Dec,2016.Setting up a database by Microsoft office Excel2.Have a description to the basic clinicopathologic characteristics of 148 collected colon cancer patients3.Drawing a ROC curve according to the survival follow up of patients and the level of preoperative HB to statistically analyze and to make sure whether there is a cut-off of DFS(disease free survival),OS(overall survival)by the analysis of the date4.Patients were divided into anemic and non-anemic groups for making a analysis of Kaplan-Meier,and observing the association between anemic and non-anemic groups and disease-free survival(DFS)and overall survival(OS)in colorectal cancer patients.5.Exploring the independent risk factor on the prognosis of colorectal cancer patients by COX univariate and multivariate regression analysis.6.Exploring the risk factors for anemia in colorectal cancer by Logistic univariate and multivariate regression analysis.Result1.ROC curve analysis showed that the AUC of preoperative hemoglobin(HB)affecting OS is 0.549(P=0.488),and that of preoperative hemoglobin affecting PFS was 0.612(P=0.053),indicating that there was no significant difference between the preoperative hemoglobin value and DFS and OS.2.Kaplan-meier method was used to analyze the influence of preoperative hemoglobin on the prognosis..The chi-square value of Log Rank(mantel-cox)test was 0.005,P=0.945.There was no statistically significant difference between the two survival curves.The chi-square value of Log Rank(mantel-cox)test was 0.096,P=0.756.There was no statistically significant difference between the two survival curves.3.Cox univariate and multivariate regression analysis showed that the right hemicolon(HR,3.894,95CI=1.507-10.058,P=0.005),T(HR,3.462,95CI=1.221-9.815,P=0.020)and M(HR,6.391,95CI=1.543-26.47,P=0.011)were independent risk factors of OS.T(HR,2.242,95CI=1.074-4.68,P=0.032),N(HR,2.165,95CI=1.064-4.403,P=0.033),M(HR,5.14,95CI=1.397-18.909,P=0.014),and degree of differentiation(HR,2.474,95CI=1.206-5.074,P=0.013)were independent factors of PFS.4.Logistic univariate and multivariate regression analysis showed that the right hemicolon(OR,6.765,95CI=6.765-15.362,P<0.001),PLR(OR,3.061,95CI=3.061-6.777,P=0.006)and serum albumin(OR,0.254,95CI=0.254-0.629,P=0.003)were independent risk factors of anemia.Conclusions1.Preoperative hemoglobin levels were not associated with prognosis in CEAnegative colon cancer patients.2.The location of colon cancer on the right,and T stage,N stage,M stage and differentiation degree are independent risk factors for CEA-negative colon cancer.3.The location of colon cancer on the right,elevated PLR(platelet/lymphocyte),and low serum albumin are risk factors for anemia. |
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