An Analysis Of Clinical Characteristics,risk Factors And Possible Causes Of Interval Colorectal Cancer

Objective:Colorectal cancer is a common malignant tumor and one of the common causes of cancer-related death.At present,colonoscopy is the main screening method for colorectal cancer.However,some people were diagnosed with colorectal cancer before the next recommended follow-up interval after a negative colonoscopy.This type of colorectal cancer is called interval colorectal cancer,which shows that colonoscopy is not perfect.The purpose of this study is to compare the clinical data of patients with interval colorectal cancer and non-interval colorectal cancer,to find out the related risk factors and clinical characteristics of interval colorectal cancer,and to analyze the possible causes of interval colorectal cancer.Methods:Interval colorectal cancer is defined as colorectal cancer that occurs within 6-36 months after a negative colonoscopy.To collect the inpatients with colorectal cancer diagnosed by pathology in the first affiliated Hospital of Kunming Medical University from 2011 to 2018,and to formulate the inclusion and exclusion criteria.l.The clinical data of 99 cases of interval colorectal cancer and 205 cases of non-interval colorectal cancer were analyzed retrospectively.Including sex,age,nationality,smoking history,drinking history,hospital grade at the time of the first enteroscopy,history of endoscopic polypectomy(including pathological results of polyps),gross location of operation and pathology,gross volume of operation,degree of gross differentiation,metastasis of periintestinal lymph nodes,family history of CRC,etc.To compare the difference between the two groups.2.The patients in I-CRC group were divided into the following three groups:omission of lesions,incomplete resection of polyps and new tumors,to clarify the possible causes of I-CRC and the proportion of each part.Results:The first colonoscopy was more likely to develop interval colorectal cancer in second-class hospitals(interval 69.70%VS non-interval 51.71%,p<0.003<0.05).Patients with a history of polypectomy were more likely to develop interval colorectal cancer(interval 25.25%VS non-interval 7.32%,P=0.001<0.05).Surgical pathology of interval colorectal cancer.Most of the patients were located in the proximal colon(interval 28.28%VS non-interval 17.07%,P<0.025<0.05),small gross volume(interval 3.52 ± 1.53VS non-interval 3.95±1.52,P=0.05<0.022),and good degree of differentiation.Most of them were highly differentiated or early stage carcinoma(interval 69.70%VS non-interval 35.12%,P<0.001<0.05),and less periintestinal lymph node metastasis(interval 15.15%VS non-interval 40.49%).P<0.001<0.05),most of them had family history of colorectal cancer(interval 6.06%VS non-interval 0.98%,p=0.009<0.05).Sex,age,nationality,smoking and drinking were not risk factors for interval colorectal cancer(P>0.05).and the main cause of interval colorectal cancer was the mission of lesions(70 cases,70.7%).Conclusion:1.Interval colorectal cancer is mainly located in the proximal colon,usually with small size,high degree of differentiation,no peri-intestinal lymph node metastasis,the endoscopic level is also related to the occurrence of interval colorectal cancer.Interval colorectal cancer is more likely to occur if there is a history of polypectomy and a family history of colorectal cancer.2.Sex,age,nationality,smoking and drinking were not risk factors for interval colorectal cancer(P>0.05).3.The mission of lesions is the main cause of interval colorectal cancer.Therefore,strengthening the quality control of colonoscopy and improving the level of endoscopic surgeons is very important to reduce the incidence of interval colorectal cancer.