Analysis Of Clinicopathological Factors Influencing Lymph Metastasis In Lateral Ligament Of Rectum Of Middle And Low Rectal Cancer Patients

Objective: We analyze the clinicopathological factors of low rectal cancer patients To investigate the risk factors on lymph metastasis in the lateral ligament of rectum.Methods: Low rectal cancer patients was recruited who were operated for laparoscopic radical surgery from January 2015 to January 2020 according to the inclusion criteria,and we collect the clinicopathological data of these recruited patients.The data comes from gender,age,body mass index,preoperative intestinal obstruction,the presence of medial rectal artery,number of lateral ligament of rectum,tumor markers,tumor size,gross types,histopathology,differentiations,lymphovascular invasion,perineural invasion,T stage,number of lymph nodes harvested,microsatellite status,K-Ras genetic mutation status and NO.253 lymph nodes.we will use the Fisher test and multivariate logistic regression models to identify the association between lymph node metastasis in lateral ligament of rectum and the data.Results: We recruited ninety-seven patients diagnosis of middle and low rectal cancer,and find out lateral ligament of rectum lymph metastasis in eleven patients.Univariate analysis showes that patients with some particular characteristics are more likey to have lymph metastasis in lateral ligament of rectum from univariate analysis,the characteristics including preoperative intestinal obstruction(P=0.001),T4 stage(P<0.001),elevated preoperative CA19-9 index(P<0.001),lymphovascular invasion(P<0.001),presence of middle rectal artery in the lateral rectal ligament(P<0.001)and positive NO.253 lymph nodes.We also konws that patients with lymphovascular invasion(OR=51.4,P<0.001)were more prone to lymph metastasis in lateral ligament of rectum from multivariate logistic regression models.Conclusion:Patients with preoperative intestinal obstruction,tumor T4 stage,presence of vascular tumor thrombus,elevated preoperative CA19-9 index,presence of middle rectal artery in the lateral rectal ligament and positive NO.253 lymph nodes are more likely exist lateral rectal ligament lymph node metastasis.If the patient has the above risk factors,it is recommended to remove the lateral rectal ligament during operation.