The Preliminary Study On The Relationship Between Appendectomy And Colorectal Cancer

ObjectiveColorectal cancer is one of the most commonly malignant tumors in adults.At present,the incidence of colorectal cancer is increasing in most countries and regions around the world,which has become a global public health problem.the patients are becoming younger and younger.And the long-term prognosis of colorectal cancer is poor,Studies have shown that the incidence of colorectal cancer are affected by many factors,such as heredity,diet,environment and so on.However,there is no conclusion whether appendectomy will affect the incidence of colorectal cancer.With the continuous progress of immunology,some studies have pointed out that appendix is a part of the immune system.a series of physiological changes have taken place in the body after appendectomy,resulting in a decline in local intestinal immunity.It may increase the risk of many intestinal diseases.The purpose of the study is to explore the relationship between appendectomy and the incidence of colorectal cancer,and to analyze other factors that may affect the incidence of colorectal cancer,so as to provide reference for clinical mastery of the indications of appendectomy and prevention and treatment of colorectal cancer.MethodsIn this retrospective study,227 patients with pathologically confirmed colorectal cancer admitted to the General Surgery Department of the 215 Hospital of Shaanxi Nuclear Industry affiliated to Xi'an Medical University between January 2015 and January 2018 were selected as the case group,and 236 non-cancer healthy people who underwent medical examination in the same period were selected as the control group.Strictly follow the inclusion and exclusion criteria,and collect the basic data of two groups of patients,including age,sex,height,weight,hypertension,diabetes mellitus,blood fat,smoking history,drinking history,appendectomy history,cholecystectomy history and so on.The patients were divided into right colon cancer,left colon cancer and rectal cancer.The diagnosis of the patients was recorded and the data were collected.The data were further analyzed,and the differences in the percentages of appendectomy history between the two groups were compared by chi-square test.The possible risk factors of colorectal cancer(including hyperlipidemia,body mass index,smoking,alcohol consumption,hypertension,diabetes mellitus,cholecystectomy history,etc.)were analyzed one by one,and the confusion was eliminated by Mantal-Haenszel stratified analysis.Factors(including sex,age,body mass index,smoking,alcohol consumption,diabetes mellitus,cholecystectomy history,etc.)influence the relationship between appendectomy and colorectal cancer.Finally,the possible risk factors such as appendectomy history,body mass index,smoking,alcohol consumption,diabetes mellitus and cholecystectomy history were analyzed by logistic regression analysis to summarize the related risk factors of colorectal cancer.Results(1)There were 227 cases of colorectal cancer in the case group,including 59 cases of right colon cancer,55 cases of left colon cancer and 113 cases of rectal cancer,113 of which were male and 114 of which were female,with an average age of 63.82 + 12.86 years.There were 236 cases in the control group,including 106 males and 130 females,with an average age of 63.36 + 10.91 years.There was no significant difference in baseline data of age and sex between the two groups(P > 0.05).The case group was comparable with the control group.(2)There were 227 cases of colorectal cancer in the case group,28 cases(12.33%)with appendectomy,236 cases in the control group and 11 cases(4.66%)with appendectomy.There was a significant difference in the percentage of appendectomy history between the two groups(P < 0.05),suggesting that appendectomy may be related to the incidence of colorectal cancer.(3)Colorectal cancer was divided into three subgroups: right,left and rectal cancer according to the location of the tumors.The percentage of appendectomy history in each subgroup was compared with that in the control group.The results showed that there were significant differences between the subgroups and the control group(all P <0.05),suggesting that the correlation between appendectomy and the incidence of colorectal cancer was not affected by the location of colorectal cancer.Influence.(4)The two groups were compared in terms of hyperlipidemia,body mass index,smoking,alcohol consumption,hypertension,diabetes mellitus and cholecystectomy history.The results of single factor analysis showed that except hyperlipidemia and hypertension,there were significant differences in other factors between the two groups(all P < 0.05),suggesting body mass index,smoking,drinking,diabetes and cholecystectomy.In addition to history and other factors may also affect the pathogenesis of colorectal cancer.(5)The risk factors of colorectal cancer such as sex,age,body mass index,smoking,drinking,diabetes mellitus and cholecystectomy history were examined by stratified analysis.The results showed that the correlation between appendectomy and colorectal cancer was not related to gender,age,body mass index,smoking,drinking,diabetes mellitus and cholecystectomy history.The effect of vegetable.(6)Finally,the risk factors of colorectal cancer P < 0.1 in univariate analysis were included in the multivariate logistic regression analysis model.The results showed that appendectomy,body mass index,smoking,diabetes mellitus and cholecystectomy history were all possible risk factors for colorectal cancer.ConclusionsThe study found that appendectomy may increase the risk of colorectal cancer through correlation study and statistical inference;and the correlation between appendectomy and colorectal cancer are not affected by the location of colorectal cancer and other risk factors of colorectal cancer.Appendicectomy may be an independent risk factor for colorectal cancer.At the same time,the study also found that body mass index,smoking,diabetes mellitus and cholecystectomy history may also be the independent risk factors of colorectal cancer.