Study On The Relationship Between Family History And Clinicopathlogic Characteristics And Prognosis In Patients With Colorectal Cancer

Objective:In order to provide basic data for colorectal cancer prevention and prognosis improvement,we explored the relationship between family history of cancer and the clinical pathological features and prognosis of colorectal cancer.Method:Cohort study design was adopted in this study.Research objects were collected retrospectively from January 2010 to December 2015 in the Affiliated Hospital of Xi’an Jiao Tong University who underwent surgical treatment and confirmed by pathology of colorectal cancer patients.The clinical data were collected including age,gender,contact type,tumor size,tumor location,degree of differentiation,TNM stage(Classification tumor nodes,metastasis,etc.).Follow-up was started of the operative time and ended at March 10,2016,or death,recurrence,metastasis,lost time.According to family history level patients were divided into tumor positive family history of colorectal cancer and tumor negative family history of colorectal cancer.SPSS 23 statistical analysis software was used in data analysis.Chi square test was used to compare the two groups on the clinical characteristic difference,Kaplan-Meier method and Log-rank test was used to compare the survival rate,Cox regression models were used to analyze the influence of multiple factors for prognostic.P < 0.05 was set up as statistically significant.Results:1.This study collected the clinical data of 948 cases,excluding 78 cases not included in the follow-up improvement,a total of 870 cases was include in the study.A total of 133 cases were lost during the study period,737 cases were followed up,the follow-up rate was 84.7%,including 192 cases of tumor positive family history(26.1%),545 cases were negative(73.9%);2.The age of the patients with positive family history of colorectal cancer was 54.1 ± 0.2years old,and the negative group was between the ages of 62.7 ±0.5.The difference was statistically significant(χ2=42.78,P=0.000);3.The length of tumor in patients with positive family history of colorectal cancer was 2.7± 0.3cm,and the negative group was 4.4 ± 0.2cm,the difference was statistically significant(χ2=41.78,P=0.000);4.The body mass index of the patients with positive tumor family history was lower than that of the negative group,and the difference was statistically significant(χ2=15.198,P=0.002);5.A family history of patients with colorectal tumor positive lymph node metastasis rate was 44.8%,compared with the negative group,the difference was statistically significant(χ2=11.441,P=0.001);6.Patients with positive family history of tumor infiltration depth of the tumor,the clinical pathological stage earlier,and the difference between the negative group was statistically significant(Z=-3.405,P-0.001);7.There was no significant difference in gender and differentiation between positive family history and negative ones(P>0.05);8.Positive family history of cancer patients with colorectal cancer 3,5 year overall survival rate(overall survival,OS),disease-free survival(disease free,survival,DFS),progression free survival(Progress free,survival,PFS)were lower than the negative,the difference was statistically significant(P<0.05).Conclusion:1.Colorectal cancer patients whose family history of tumor positive showed early age of onset,smaller tumor size at diagnosis,infiltration depth,lymph node metastasis rate and early tumor TNM stage,which suggesting that family history of colorectal cancer patients with domestic tumor positive negative can be detected and diagnosed earlier;2.Although domestic and family history of tumor positive colorectal cancer patients compared to negative patients can achieve early detection and early diagnosis,but the prognosis of patients with positive family history of cancer was negative,which suggesting that due to the inherent virulence genes,disease progression and family history of tumor positive colorectal cancer,treatment effect is poor.Tumor family history for colorectal cancer is independent prognostic factors.Innovative:1.Clinical features of colorectal cancer patients with family history of cancer were described firstly in China;2.The prognosis and determinates of colorectal cancer patients with family history of cancer were exploded firstly in China,which provided important theoretical support for screening and early prevention and clinical treatment of high risk groups with positive family history.