Study On The Relationship Between Vascular Invasion And Lymph Node Metastasis In Colorectal Cancer

Background and purpose:Colorectal cancer is a malignant tumor with high morbidity,recurrence and mortality.Important prognostic indicators are related to lymph node metastasis.Early intervention can block its progress in time to prolong survival.This study collects clinical data of patients with vascular invasion and non-vascular invasion,discusses the relationship between lymph node metastasis and vascular invasion,and hopes to provide a reference for patients with Lymphovasular Invasion to predict the risk of lymph node metastasis after surgery.Research method:In this study,we selected colorectal cancer patients who underwent radical surgery in the Shaanxi Provincial People's Hospital from January 2014 to December 2018.A total of 467 patients were selected according to the inclusion and exclusion criteria.All relevant examinations were completed before the operation and the postoperative pathological report was complete.According to the postoperative pathological results,patients with vascular invasion were divided into 180 cases of lymph node metastasis group(LNI group),149 cases without lymph node metastasis group(NLNI),and 138 cases without vascular invasion and lymph node metastasis were the control group.Data collected included the patient's gender,age,smoking history,preoperative intestinal obstruction,tumor size,degree of differentiation,depth of invasion,CEA,CA19-9,vascular infiltration,nerve infiltration,and lymph node metastasis.The data of LNI group,NLNI group and control group were analyzed using SPSS18.0 software to discuss the risk factors of vascular infiltration and lymph node metastasis and the correlation between vascular infiltration and lymph node metastasis.Research result:1.LNI group,NLNI group,control group ?60 years old accounted for 68.9%,70.5%,60.1%,no significant difference between the groups(P>0.05);LNI group,NLNI group,control group The proportion of males was 57.2%,56.4%,and 57.2%,respectively,and there was no statistically significant difference between the groups(P>0.05).2.The proportions of smoking history in the LNI group,NLNI group,and control group were 26.1%,29.5%,and 34.1%,respectively,and there was no statistically significant difference between the groups(P>0.05);LNI group,NLNI group,and control group The proportion of T1 is 0.6%,3.4%,13.8%,T2 is 3.3%,7.4%,15.9%,T3 is 22.8%,27.5%,34.1%,T4 is 73.3%,61.7%,36.2% The differences between the groups were statistically significant(P<0.05).3.The proportion of intestinal obstruction in LNI group,NLNI group and control group was 19.4%,10.1% and 8.7%,only the difference between LNI group and control group was statistically significant(P<0.05);LNI group,NLNI group and control group The proportion of tumor diameter ?5cm in the group was 26.1%,27.5%,and 22.6%,and there was no statistically significant difference between the groups(P>0.05).4.The proportion of nerve infiltration in the LNI group,NLNI group and control group was 71.1%,77.2% and 29.7%,respectively.The difference between the groups was statistically significant(P<0.05);the LNI group,NLNI group and control group were high The proportions of differentiation were 27.2%,38.9%,and 37%,medium differentiation were 51.1%,45%,and 55.8%,and low differentiation were 21.7%,16.1%,and 7.2%,respectively.The differences between the groups were statistically significant.(P<0.05).5.The proportions of CEA?5ug/L in LNI group,NLNI group and control group were 35.6%,35.6% and 24.6%,respectively,and the differences between the groups were statistically significant(P<0.05);LNI group,NLNI group,The proportions of CA19-9?37u/ml in the control group were 22.2%,17.4%,10.9%,only the difference between the LNI group and the control group was statistically significant(P<0.05).6.Logistic regression analysis of influencing factors in LNI group and NLNI group:the degree of tumor differentiation(OR = 1.550),depth of infiltration(OR = 3.248),and nerve infiltration(OR = 4.921)were independent risk factors of LNI group;depth of invasion(OR = 1.811),nerve infiltration(OR = 8.586)is an independent risk factor for the NLNI group.Conclusions:1.The degree of tumor differentiation,depth of invasion,and nerve invasion are independent risk factors for lymph node metastasis of colorectal cancer with vascular invasion.2.Infiltration depth and nerve infiltration are independent risk factors for vascular invasion of colorectal cancer without lymph node metastasis.