Analysis Of Clinicopathological Factors Influencing No.253 Lymph Node Metastasis In Colorectal Cancer Patients

Objective:To explore the risk factors on No.253 lymph node metastasis by analyzing the clinicopathological factors of colorectal cancer patients in our hospital.Methods:A retrospective study was performed by collecting the clinicopathological data of 153 patients who were diagnosed with rectal cancer and sigmoid colon cancer and were operated for laparoscopic D3radical surgery from September 2017 to October 2018.The data included gender,age,BMI,tumor location,preoperative obstruction,tumor markers(CEA,CA19-9 and CA72-4),tumor size,tumor border,histopathology,tumor differentiation,lymphovascular invasion,perineural invasion,T stage,number of lymph nodes harvested,microsatellite status and Ras genetic mutation status.The association between No.253 lymph node metastasis and the data above were evaluated.Additionally,multivariate logistic regression models were performed to identify the risk factors for No.253 lymph node metastasis.Results:Eight patients(5.23%)of the 153 patients enrolled in the study were detected No.253 lymph node positive.Univariate analysis showed that patients with the following characteristics had a significantly higher rate of No.253 lymph node metastasis:tumor location(10cm above the anal verge,χ~2=6.872,P=0.009),preoperative obstruction(χ~2=4.711,P=0.030),CEA(>5.0ng/ml,χ2=6.552,P=0.010),CA19-9(>27.0U/ml,χ2=5.778,P=0.016),tumor size(≥5cm,χ2=5.364,P=0.021),poorly differentiated(χ~2=4.317,P=0.038),lymphovascular invasion,(χ~2=31.64,P<0.001),perineural invasion(χ2=6.088,P=0.014)and T4 stage(χ2=18.530,P<0.001).Multivariate logistic regression models showed that patients with lymphovascular invasion(OR=7.101,P=0.008)were more prone to No.253lymph node metastasis.Conclusions:The risk factors of the No.253 lymph node metastasis were tumor location,preoperative obstruction,preoperative CEA level,preoperative CA19-9 level,tumor size,tumor differentiation,lymphovascular invasion,perineural invasion and T 4stage.Multivariate analysis showed that lymphovascular invasion was an independent risk factor for No.253 lymph node metastasis.No.253 lymphadenectomy was suggested to be performed on the patients with the characteristics above.