Analysis Of Risk Factors Related To Lymph Node Metastasis Of Preoperative Colorectal Cancer

Objective: To discuss the correlation between lymph node metastasis of colorectal cancer and clinicopathological factors and serum tumor markers before operation,and to explore the prognostic risk factors of colorectal cancer.Provide a reference for clinical diagnosis and treatment of colorectal cancer.Methods: A retrospective medical record controlled study was used to collect the research data of 210 patients with colorectal cancer from January 2015 to December 2016 in Shaanxi Provincial People's Hospital.According to the inclusion criteria:(1)preoperative endoscopic examination,biopsy results confirmed the diagnosis of colorectal cancer;(2)Complete tumor resection and specimens for postoperative pathological biopsy;(3)Patient medical records and relevant data of the study are complete;(4)All patients undergo radical surgery;(5)Tolerable surgery before surgery and consent to surgery treatment.Exclusion criteria:(1)those who received adjuvant therapy before surgery;(2)excluded history of hematological diseases;(3)excluded patients with multiple primary lesions;(4)preoperative tumor markers and serum albumin and hemoglobin were collected for more than 2 weeks.Collect general patient data,laboratory examination data,pathological examination data,surgical data and postoperative follow-up data for analysis.Two-factor single-factor analysis of colon cancer and rectal cancer were conducted to explore the significant factors of lymph node metastasis.Constructing a logistics multi-factor regression model to analyze the risk factors of lymph node metastasis.Kaplan-Meier was used for survival analysis,and a COX risk proportional model was established to explore independent risk factors that affect survival time after colorectal cancer surgery.Results: 1.103 cases of colon cancer,the positive rate of lymph nodes was 43.7%.In 107 cases of rectal cancer,the positive rate of lymph nodes was 38.3%.2.Two-factor single factor analysis of clinical data of colon cancer and rectal cancer,the results suggest the age,sex,smoking history,alcoholism,hypertension,diabetes history,preoperative serum hemoglobin(Hb),preoperative Serum albumin(ALB)was not associated with lymph node metastasis of colorectal cancer(P> 0.05).Preoperative serum glycoprotein antigen 19-9(CA19-9)was not associated with colon cancer lymph node metastasis(P = 0.386),but was associated with rectal cancer lymph node metastasis(P = 0.011).3.Preoperative intestinal obstruction,degree of tumor differentiation,and preoperative serum carcinoembryonic antigen(CEA)were all associated with colon and rectal cancer lymph node metastasis(P <0.05).Logistic multivariate analysis showed that preoperative intestinal obstruction,tumor differentiation,and preoperative serum CEA were all independent factors affecting lymph node metastasis in colon and rectal cancer(P <0.05).4.Survival analysis results show that lymph node metastasis has an important effect on the survival time of colorectal cancer after surgery(Log-rank P = 0.001).COX risk model analysis of relevant risk factors that have an impact on the prognosis of colorectal cancer,suggesting that the prognostic risk factors include lymph node metastasis,tumor differentiation,preoperative bowel obstruction,preoperative serum CEA,preoperative serum CA19-9 and preoperative serum Hb.And lymph node metastasis,preoperative intestinal obstruction,tumor differentiation,preoperative serum CEA are independent risk factors that affect the survival time of colorectal cancer after surgery.Conclusions: 1.Preoperative intestinal obstruction,degree of tumor differentiation,and preoperative serum CEA are common independent risk factors affecting lymph node metastasis of colon cancer and rectal cancer.2.COX univariate analysis showed that lymph node metastasis,tumor differentiation,preoperative intestinal obstruction,preoperative serum CEA,preoperative serum CA19-9 and preoperative serum Hb were related to the survival time of colorectal cancer.Multivariate analysis showed that lymph node metastasis,tumor differentiation,preoperative bowel obstruction,and preoperative serum CEA were independent risk factors that affected the survival time of colorectal cancer.