| Objective:To investigate the correlation between lymphovascular invasion and clinicopathological factors such as tumor diameter,T stage and lymph node metastasis in patients with colorectal cancer and its effect on prognosis.Methods:The clinicopathological data of 473 patients with colorectal cancer who underwent radical resection in the Colorectal-anal Surgery Department of the First Affiliated Hospital of Guangxi Medical University from January 2015to December 2015 were retrospectively analyzed.According to the set inclusion and exclusion criteria,406 patients were screened,among which clinical pathology showed that 55 patients were positive and 351 patients were negative for lymphovascular invasion.All patients were followed up by outpatient review or telephone follow-up until January 31,2021,and the survival of the patients was observed and recorded.Age,gender,preoperative CEA,CA199,D-dimer level,tumor diameter,degree of differentiation,depth of invasion,lymph node metastasis and nerve invasion in 2 groups were tested by chi-square test and Logistic regression analysis to find the correlation between the above clinicopathological factors and vascular tumor thromboembolism.Kaplan-Meier method was used to calculate the survival rate.Log-rank test was used for univariate analysis and survival curve distribution of each group,and Cox proportional risk regression model was used for multivariate analysis to study the related factors affecting the prognosis of colorectal cancer.Results:1.Univariate analysis showed that CEA,CA199,T stage,nerve invasion,lymph node metastasis were correlated with vascular tumor emboli of colorectal cancer.Logistic regression analysis showed that lymph node metastasis and nerve invasion were closely related to vascular tumor thrombus（P<0.05）.OR nerve invasion=8.371（95%CI:3.612-19.401）,OR lymph node metastasis=3.520（95%CI:1.772-6.991）.2.Kaplan-Meier method showed that the depth of invasion,lymph node metastasis,nerve invasion,abnormal D-dimer and vascular cancer emboli were correlated with survival rate,（P<0.05）.Cox regression analysis showed that positive vascular emboli,depth of tumor invasion,abnormal D-dimer and lymph node metastasis were closely related to the survival rate of colorectal cancer（P<0.05）.The 3-year and 5-year survival rates of 406 patients were 68.5%and61.2%,respectively.The mean survival time of the group with lymph node metastasis and the group without lymph node metastasis were 53.4 months and63.4 months.The mean survival time of the lymphovascular invasion group and the non-lymphovascular invasion group were 48.2 months and 60.6 months.The mean survival time of the nerve invasion group and the non-nerve invasion group were 48.6 months and 59.8 months.The mean survival time of normal CEA group and abnormal CEA group were 60.8 months and 55.8 months.The mean survival time of CA199 normal group and CA199 abnormal group were59.0 months and 58.8 months.The mean survival time of T1-2 group and T3-4group were 63.7 months and 57.0 months.The mean survival time of D-dimer normal group and D-dimer abnormal group were 60.2 and 50.2 months respectively.Univariate analysis showed that CEA,CA199,T stage,nerve invasion,lymph node metastasis and lymphovascular invasion of colorectal cancer were statistically significant（P<0.05）.There were statistically significant differences in the correlation between lymphovascular invasion,lymph node metastasis,depth of tumor invasion and prognosis and survival of colorectal cancer patients（P<0.05）.HR risk ratio and 95%confidence interval were HR lymphovascular invasion=1.516（0.988,2.328）;HR infiltration depth=1.629（1.030,2.577）;HR lymph node metastasis=1.708（1.223,2.384）;HRD-dimer=1.730（1.131,2.646）.Conclusion:1.The formation of lymphovascular invasion in colorectal cancer is positively correlated with CEA,CA199,T stage,nerve invasion and lymph node metastasis,among which lymph node metastasis and nerve invasion are independent influencing factors of lymphovascular invasion in colorectal cancer.2.The prognosis of colorectal cancer is related to lymphovascular invasion,tumor invasion depth,nerve invasion,lymph node metastasis,and D-dimer abnormality,and lymphovascular invasion,tumor invasion depth,lymph node metastasis,and D-dimer abnormality are independent risk factors affecting the prognosis of colorectal cancer. |
