Epidemiological Characteristics Of Colorectal Cancer In Qingdao Area Of Shandong Province

Background and objective:The morbidity and mortality of colorectal cancer(colorectal cancer,CRC)are still among the forefront both in China and the world.In 2018,the number of new cases of CRC in the world exceeded 1.8 million and the number of deaths was 881000 Among all kinds of cancers,CRC has the third highest morbidity(10.2%)and the second highest fatality rate(9.2%)in the world.However,it is worth noting that after years of unremitting efforts,the morbidity of CRC in the United States has begun to decline gradually,while in China,the morbidity and mortality of CRC have been maintained at a very low level for a long time,but have increased rapidly in recent years.China has a large population base,and the increasing trend of the absolute number of morbidity and death of CRC is more obvious.CRC has seriously affected the quality of life and health of the people,but also a heavy burden on families and society.Distant metastasis of CRC is the main cause of poor prognosis and high mortality,and the liver is often the only organ involved.The factors affecting the occurrence of CRC and liver metastasis of colorectal cancer(colorectal liver metastases,CRLM)are numerous and complex.China is not only a big country with HBV infection,but also a big country with fatty liver disease.China also has a rich alcohol culture and a large number of drinkers,so it is of great significance to analyze the epidemiological characteristics of CRC and the related influencing factors of CRLM in China.Through a clinical retrospective cross-sectional study of a large sample of 3172 consecutive cases of CRC in a single regional medical center(affiliated Hospital of Qingdao University)for 6 years,our team analyzed the epidemiological characteristics of CRC and the related factors of synchronous colorectal cancer liver metastasis(synchronous colorectal liver metastasis,synCRLM)in Qingdao area of Shandong Province,in order to provide clinical guidance and basis for the prevention,diagnosis,treatment and prognosis of CRC.It also provides objective data support for the study of related factors between concomitant diseases and distant metastasis of tumorsMethods:A total of 3172 CRC patients were collected consecutively from January 2010 to January 2016 in Qingdao area of Shandong Province,who were treated in the affiliated Hospital of Qingdao University.All patients were diagnosed as CRC by biopsy.The basic information and clinicopathological data of all patients were collected,and the epidemiological characteristics of CRC and the related factors affecting synCRLM were analyzed in many aspects,such as age,sex,location of lesion,pathological type and degree of differentiation,tumor size,TNM stage and distant organ metastasis,main clinical manifestations,past medical history,address of residence,laboratory examination index and so onThe above data were processed and analyzed in SPSS22.0 statistical software,and the test level was 0.05(bilateral).The difference was statistically significant(p<0.05)Results:The age distribution of CRC ranges from 21 to 97 years old,the median age is 63 years old,the average age is 62.84±11.87(M±SD)years,and the high incidence age group is 60 to 69 years old.Before the age of 69(inclusive),the prevalence rate among all age groups increased with age,and the prevalence rate of males was significantly higher than that of females(61.35%vs.38.65%).The ratio of males to females was 1.59:1,and there were more males than females in all age groups.Colon cancer is more than rectal cancer(51.67%vs.47.92%),and left colon cancer is more than right colon cancer(30.64%vs.21.03%).Among the specific lesions,rectal cancer is the most common,and ascending colon cancer is significantly higher than descending colon cancer(14.97%vs.3.18%).In the pathological classification of CRC,adenocarcinoma was the most common(93.98%),followed by mucinous adenocarcinoma(5.20%).In the degree of differentiation of adenocarcinoma,the type of middle differentiation is the most common,and the type of low differentiation is significantly more than that of high differentiation.The pathological type and degree of differentiation of young people are often worse and the disease is more serious than that of the elderly.The diameter of tumor in male was larger than that in female,the diameter of tumor in low age group was larger than that in high age group,the diameter of colon cancer was larger than that of rectal cancer,and the diameter of right colon cancer was larger than that of left colon cancer.At the time of treatment,the vast majority of patients had late T stage(T3 and T4),N stage NO was the most common(59.54%).17.59%of the patients had distant organ metastasis,and liver metastasis was the most common in M1(49.64%),synCRLM prevalence rate was 8.73%.Among the main complaints of patients,bloody stool,abdominal distension and abdominal pain,stool frequency changes/defecation difficulties are the most common,while fever and anemia are the least common,and only 0.66%of the patients are found by physical examination.people do not have high awareness of physical examination and seek medical treatment only when they have obvious clinical manifestations.Most of the patients with CRC have previous medical history and mainly live in economically developed areas.The positive rate of combined detection of CEA and CA19-9 was significantly higher,which was more valuable in distant organ metastasis,recurrence and prognosis.Sex,location,differentiation,tumor size,depth of invasion,number of lymph node metastasis,main clinical manifestations,fatty liver and HBV infection,triglyceride,cholesterol,CEA and CA19-9 were closely related to the occurrence of synCRLM.Sex,HBV infection,CEA,CA19-9,AST and GGT were independent risk factors for synCRLMConclusion:CRC patients in Qingdao area have their own characteristics in many aspects,such as age,sex,location of lesions,pathological type and differentiation,tumor diameter,TNM stage and distant organ metastasis,main clinical manifestations,past medical history,residential address,laboratory examination index and so on.Sex,tumor location,differentiation,tumor diameter,depth of invasion,fatty liver,HBsAg+,neutrophil count,lymphocyte count,PLT,ALT,AST,TBIL,GGT,triglyceride,cholesterol,CEA,CA19-9 were closely related to the occurrence of synCRLM.The highest independent risk factor of synCRLMORR was HBsAg+,lymphocyte count and TG were independent protective factors affecting synCRLM.