Risk factors of mesentery metastases and survival analysis of T1,T2 colorectal cancer

doi:10.3877/cma.j.issn.1647-0793.2013.03.006

Abstract

Abstract:

Objective

To investigate the risk factor of local metastases and impact factors of survival for tumor invasion depth as T1,T2 colorectal cancer.

Methods

Kaplan-Meier model was applied to analyze the long-term survival of 260 colorectal cancer patients. The biomarkers density in tumor invasion frontier were analyzed by immunohistochemistry. Risk factors were studied by COX regression univariated or multivariated analysis.

Results

Two hundred and sixty cases of T1,T2 colorectal cancer were collected, among them 218 were negative and 42 were positive. The positive group showed poorer result of 3 years disease free survival(DFS) and 5 years overall survival(OS) than the negative group(P < 0.01). Multivariated analysis indicated the risk factors included female, histology, lymphovascular or perineural invasion, preoperative CEA level >5 μg/L. CD80 expression in negative local metastases appeared higher than positive group.

Conclusions

Lymph node metastases and/or isolated tumor deposits are negative prognostic factors for T1,T2 colorectal cancer, and the patients should be selected strictly to receive local excision. Female, histology, lymphovascular or perineural invasion, preoperative CEA level >5 μg/L were risk factors of local metastases. CD80 high expression in tumor invasion frontier could be a protective factor.

Key words: Colorectal cancer, Lymph node metastases, Isolated tumor deposits, Survival analysis, Risk factor

Yang ZENG, Xiao-sheng HE, Lei LIAN, Xiao-jian WU, Jin-ping MA, Jian-ping WANG, Ping LAN. Risk factors of mesentery metastases and survival analysis of T1,T2 colorectal cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2013, 07(03): 188-192.

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References 18

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临床资料	结肠(72例)	直肠(188例)	P值
T1/T2	19/53	35/153	0.305
年龄（岁）	60	61	0.784
性别（男/女）	46/26	105/83	0.267
阳性淋巴结/癌结节[n(%)]	10(13.9)	32(17.0)	0.083
BMI（kg/m²）	21.9±3.1	22.1±3.2	0.147
吸烟史[n(%)]	15(20.8)	26(13.8)	0.169
饮酒史[n(%)]	7(9.7)	7(3.7)	0.076
肿瘤大小(cm)	3.7±2.0	3.6±1.5	0.432
血清CEA > 5μg/L[n(%)]	10(13.9)	23(12.2)	0.210
血清CA19-9 > 37 IU/ml[n(%)]	4(5.6)	18(9.6)	0.097

临床资料	结肠(72例)	直肠(188例)	P值
T1/T2	19/53	35/153	0.305
年龄（岁）	60	61	0.784
性别（男/女）	46/26	105/83	0.267
阳性淋巴结/癌结节[n(%)]	10(13.9)	32(17.0)	0.083
BMI（kg/m²）	21.9±3.1	22.1±3.2	0.147
吸烟史[n(%)]	15(20.8)	26(13.8)	0.169
饮酒史[n(%)]	7(9.7)	7(3.7)	0.076
肿瘤大小(cm)	3.7±2.0	3.6±1.5	0.432
血清CEA > 5μg/L[n(%)]	10(13.9)	23(12.2)	0.210
血清CA19-9 > 37 IU/ml[n(%)]	4(5.6)	18(9.6)	0.097

项目		阳性组（42例）	阴性组（218例）	P值
年龄（岁）		57±12	61±12	0.807
性别（男/女）		18/24	133/85	0.029
肿瘤部位		?	?	?
?	结肠	10(23.8)	62(28.4)	?
?	直肠	32(76.2)	156(71.6)	0.539
BMI（kg/m²）		22.2±3.3	22±3.1	0.72
吸烟史		6(14.3)	35(16.1)	0.773
饮酒史		2(4.8)	13(6.0)	0.76
组织学分型		?	?	?
?	腺癌	36(85.7)	214(98.2)	< 0.001
?	黏液腺癌/印戒细胞癌	6(14.3)	4(1.8)	?
分化程度		?	?	?
?	G1	5(11.9)	69(31.6)	?
?	G2	30(71.4)	146(67.0)	< 0.001
?	G3	7(16.7)	3(1.4)	?
脉管浸润		8(19.0)	6(2.8)	0.007
神经浸润		4(9.5)	1(0.4)	0.000
肿瘤大小(cm)		4.1±1.5	3.5±1.7	0.406
肿瘤形状		-	-	0.002
血清CEA>5 μg/L		10(23.8)	23(10.6)	0.018
血清CA19-9>37 IU/ml		5(11.9)	17(7.8)	0.381

项目		阳性组（42例）	阴性组（218例）	P值
年龄（岁）		57±12	61±12	0.807
性别（男/女）		18/24	133/85	0.029
肿瘤部位		?	?	?
?	结肠	10(23.8)	62(28.4)	?
?	直肠	32(76.2)	156(71.6)	0.539
BMI（kg/m²）		22.2±3.3	22±3.1	0.72
吸烟史		6(14.3)	35(16.1)	0.773
饮酒史		2(4.8)	13(6.0)	0.76
组织学分型		?	?	?
?	腺癌	36(85.7)	214(98.2)	< 0.001
?	黏液腺癌/印戒细胞癌	6(14.3)	4(1.8)	?
分化程度		?	?	?
?	G1	5(11.9)	69(31.6)	?
?	G2	30(71.4)	146(67.0)	< 0.001
?	G3	7(16.7)	3(1.4)	?
脉管浸润		8(19.0)	6(2.8)	0.007
神经浸润		4(9.5)	1(0.4)	0.000
肿瘤大小(cm)		4.1±1.5	3.5±1.7	0.406
肿瘤形状		-	-	0.002
血清CEA>5 μg/L		10(23.8)	23(10.6)	0.018
血清CA19-9>37 IU/ml		5(11.9)	17(7.8)	0.381

因素	危险度（95% CI）	P值
性别	2.457(1.092~5.530)	0.030
血清CEA>5 μg/L	3.577(1.208~10.597)	0.021
血清CA19-9	2.327(0.965~5.395)	0.561
组织学	5.603(1.574~54.706)	0.003
分化程度	3.67(1.471~9.155)	0.001
脉管浸润	7.675(1.581~37.265)	0.011
神经浸润	3.062(1.685~37.087)	0.023
肿瘤形状	1.344(0.977~1.938)	0.236
肿瘤大小	3.342(0.838~9.876)	0.549

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