Comparative Analysis Of Lymphovascular Invasion In T3M0M0 Stage Colorectal Cancer

Background and Purpose:Colorectal cancer is one of the most common malignant tumors in the world,with the morbidity and mortality in the top rank.And the majority of patients are in late stage since they have been diagnosed.With the large heterogeneity of colorectal cancer,the prognosis of patients with the same stage of may be very different,so understanding the clinical pathologic factors of tumor is very important.Lymphovascular tumor emboli are closely associated with tumor invasion and metastasis.Patients with positive lymphovascular tumor emboli are usually accompanied by lymph node metastasis.AJCC and NCCN have clearly indicated that lymphovascular invasion is one of the factors for poor prognosis of colorectal cancer.Postoperative adjuvant chemotherapy is required when lymphovascular invasion occurs in patients with T3N0M0 stage colorectal cancer.However,due to the differences in the detection techniques of lymphovascular invasion,the detection rate of lymphovascular invasion varies greatly resulting in many false negations,which may reduce the value of vascular cancer thromboembolus and lead to insufficient understanding.Meanwhile,Some patients with T3N0M0 stage colorectal cancer with positive lymphovascular tumor thrombus did not receive chemotherapy for various reasons.By collecting clinical data,this paper retrospectively analyzed the pathological factors related to T3N0M0 stage vascular cancer thrombus and performed prognosis analysis,so as to deepen the understanding of T3N0M0 stage colorectal vascular cancer thrombus.Methods:By consulting the medical record system,the clinicopathological and follow-up data of 190 patients with colorectal adenocarcinoma who underwent surgical treatment and were pathologically diagnosed as T3N0M0 stage in our hospital from January 2012 to January 2018 were collected.Chi-square test and binary Logistic regression analysis were used to retrospectively study the clinicopathological factors related to vascular embolism of T3N0M0 stage colorectal cancer,and P < 0.05 was statistically significant.The 5-year survival rate and disease-free survival rate were calculated by Kaplan-Meier method.Log-rank test was used to analyze the significance of clinicopathological factors and survival conditions.Cox regression model was used to analyze the multivariate survival of statistically significant factors.Two-sided test was used in all cases,P<0.05 was considered statistically significant.Results:Univariate analysis was performed on 190 patients with T3N0M0 stage colorectal cancer,and the results showed that lymphovascular invasion were correlated with anemia,platelet elevation,degree of differentiation,nerve invasion(P < 0.05).There was no significant correlation between lymphovascular invasion and age,sex,diabetes,intestinal obstruction,hypoalbuminemia,CEA,CA199,surgical method,tumor location,tumor size,tumor shape,lymph node detection number,KI67,P53,HER-2(P > 0.05).Differentiation degree and nerve invasion were independent risk factors for lymphovascular invasion(P < 0.05).Disease-free-survival time was correlated with age,CEA,CA199,the number of lymph nodes detected,vascular emboli,and nerve invasion(P < 0.05).Cox multivariate analysis showed that age,lymphovascular invasion,lymph nodes detected,and CA199 were independent prognostic factors for disease-free-survival time.Overall survival time was correlated with age,CEA,number of lymph nodes detected,vascular tumor thrombus and nerve invasion(P < 0.05).Age and lymphovascular invasion were independent risk factors for overall survival time(P < 0.05).Conclusion:1.Differentiation degree and nerve invasion are independent risk factors for lymphovascular invasion of T3N0M0 stage colorectal cancer.2.Lymphovascular invasion and age are independent prognostic indicators of overall survival time in T3N0M0 stage colorectal cancer,while age,vascular thrombus,number of lymph nodes detected and CA199 are independent prognostic indicators of disease-free survival time.3.Lymphovascular invasion is a high risk factor for recurrence in T3N0M0 stage colorectal cancer.Patients can benefit from adjuvant chemotherapy,and postoperative chemotherapy should be performed in time when condition permits.