Analysis Of Risk Factors For Recurrence And Metastasis After Radical Resection And Chemoradiotherapy In Locally Advanced Rectal Cancer

Objective:To investigate risk factors for recurrence and/or metastasis after radical resection and chemoradiotherapy in patients with locally advanced rectal cancer through retrospective study.Methods:Retrospectively collected cases of patients with stage II-III rectal cancer who were admitted to the First Affiliated Hospital of Nanchang University from January 1,2009 to January 1,2017 and who underwent radical surgery and chemoradiotherapy.Relevant clinical pathological data and follow-up data were analyzed.According to the inclusion and exclusion criteria,67 cases of stage II-III rectal cancer confirmed by operation and pathology were collected.37 cases of recurrence and metastasis occurred during the follow-up observation period as the recurrence and metastasis group,30 cases with no recurrence and metastasis were found as a control group,and the follow-up time was 5 years.According to the relevant references,age,gender,tumor differentiation,preoperative CEA,CA125,CA153,CA199 and CA724 levels,preoperative triglyceride,cholesterol,high density lipoprotein,low density lipoprotein and apolipoprotein A levels were selected.Whether preoperative sedation with anemia,preoperative hypoalbuminemia,preoperative intestinal obstruction,postoperative pathological specimens to detect the number of lymph nodes,the largest diameter of the tumor,whether to invade the relevant clinicopathological factors such as vascular and nerve candidate markers for risk factors associated with recurrence and metastasis after radical resection and chemoradiotherapy of locally advanced rectal cancer.Statistical analysis was performed with SPSS 20.0 software package.The t-test and X2 test were used to compare the single-factor analysis of each observation index of the recurrence-transfer group and the control group,and then the index with strong correlation among the two-factor analysis results between the two groups,And clinically considered meaningful indicators for logistic regression for multivariate analysis.Then follow-up of the survival of the two groups of patients,draw a survival curve for analysis,visually observe the differences,and provide a reference for clinical.Results:Univariate analysis of the recurrent metastasis group and the control group showed that preoperative CEA,CA125,and high-density lipoprotein levels were associated with recurrence and metastasis after radical resection and chemoradio-therapy;age,sex,and tumor differentiation;The preoperative CA153 level,the maximum diameter of the tumor,whether or not the vascular and nerve is involved and so on has nothing to do with recurrence and metastasis.Multivariate analysis showed that preoperative CEA level,CA125 level,high-density lipoprotein level and preoperative intestinal obstruction were independent risk factors for recurrence and metastasis after radical resection and chemoradiotherapy in patients with rectal cancer.Conclusion:Rectal cancer patients with preoperative intestinal obstruction or with high serum concentration of CEA、CA125 or high-density lipoprotein are more likely to have recurrence and metastasis.