Analysis Of Risk Factors Of Lung Metastasis In Colorectal Cancer

Introduction:Colorectal cancer(colorectal cancer,CRC)is one of the common malignant tumors that currently threaten human health and life,and recurrence and metastasis are the leading causes of treatment failure and even death in CRC patients.Lung is one of the most common distant metastatic organs after the liver in patients with CRC,which accounting for 30%of all metastatic colorectal cancer.However,because of its relatively mild invasive nature,there was a relatively scarce research on the lung metastasis of CRC(LMCRC)compared with the liver metastasis of colorectal cancer,whether in it is the degree of attention,comprehensive treatment concept or related clinical and basic research.Current research has concluded that tumor cells are first transferred to the liver by blood and then transferred to the lungs through blood.About Two-thirds of LMCRC patients were accompanied by hepatic metastases,but the remaining one-third of LMCRCs had isolated pulmonary metastases.At present,there is no clear study on the real risk factors of LMCRCs.Objective:To investigate the risk factors affecting lung metastasis of colorectal cancer.Methods:This study retrospectively analyzed the images and case data of patients with colorectal cancer admitted to Sir Run Run Shaw Hospital of Zhejiang University from June 2014 to June 2017,including age,sex,BMI,gene mutation,TNM staging,tumor location,bone metastasis,tumor makers,lymph node invasion and treatment means(surgery,radiotherapy,chemotherapy and anti-vascular therapy).The clinical risk factors of lung metastasis in colorectal cancer were screened by single factor analysis of variance.A multi-factor logistic regression was carried out to determine the independent risk factors of LMCRC,Results:The study included a total of 263 patients,including 187 patients with liver metastasis in colorectal cancer and 76 lung metastasis in colorectal cancer.There were 165 males and 98 females,with an average age of 61 years old(26-89 years old).Single factor analysis showed that there was a correlation among TNM staging,grading,tumor location,KRAS gene,chemotherapy,radiotherapy,surgery and lymph node invasion and LMCRC.And the multi-factor analysis showed that there were statistically significant differences in KRAS gene mutation,high TNM staging,low tumor differentiation degree,complicated with LMCRC.while there was no significant correlation between tumor location,chemotherapy,radiotherapy,surgery and lymph node invasion and lung metastasis of colorectal cancer.Conclusion:The independent risk factors of LMCRC compared with hepatic metastasis are KRAS gene mutation,low tumor differentiation degree and high TNM staging.