Clinicopathological Characteristics And Prognosis Analysis Of Young Patients With Colorectal Cancer

Objective:To study the clinicopathological characteristics and prognosis of young patients with colorectal cancer and elderly patients to understand their characteristics and rules.Analyzing the prognostic factors to provide ideas for clinicians in early diagnosis and treatment of young patients,and improve their prognosis.Methods:Collecting the clinical and postoperative pathological data of young(136 cases,age <45)and elderly(136 cases,age 60-70)patients with colorectal cancer in Shanxi people’s Hospital from August 2014 to January 2020,and recording the survival status of the patients by telephone follow-up.The clinicopathological features were compared by SPSS 26 software package,and P < 0.05 was considered to be statistically significant.Using Kaplan Meier method to draw the survival curve and log rank test to compare the survival rate.Cox regression model was used to analyze the risk factors affecting the prognosis.Results:136 young patients,mean age 41.76 ± 5.29 years,and 258 old patients met the inclusion criteria,136 were randomly selected from the elderly patients as controls in a 1:1 ratio,mean age 64 ± 2.83 years.Young adults had a higher proportion of family history of cancer(P =0.043),higher CA199 positivity(P = 0.036)and MRF positivity(P = 0.047)than young adults with rectal cancer.Regarding postoperative pathology,the younger age group had a larger tumor size(P < 0.001),a higher proportion of tumors occurred in the rectum(P =0.049),a later N stage(P = 0.035),less differentiated(P = 0.019)and a larger proportion of tumor thrombi in the vasculature(P = 0.033).However,there was no statistical significance in terms of gender,anemia,hypoalbuminemia,BMI,diabetes mellitus,first symptoms,cancerous ileus,CEA,EMVI of rectal cancer,treatment modality,pathological stage,T stage,gross type,histological classification,organ invasion,nerve invasion,cancer nodules,and immunohistochemistry.The 5-year survival rate was not statistically significant between the younger and older patient groups(69% vs 61.8%,P = 0.386).The Cox regression model univariate analysis suggested that CA199 positivity,postoperative pathological stage,N stage,perineural invasion,intravascular tumor thrombus,and change in bowel habit were factors affecting the prognosis of young patients with CRC.After multivariate analysis suggested that CA199 positive patients had a higher mortality risk than negative patients,exp(b)= 2.915(95% CI: 1.353-6.281),and pathological stage IV was also an independent risk factor contributing to the increased mortality risk of patients,exp(b)= 9.865(95% CI:1.84-52.89).Conclusion:Young patients with colorectal cancer differ from older patients in clinicopathological characteristics,but this difference does not contribute to a change in overall survival.It is advocated that high-risk individuals and young individuals with associated symptoms receive enteroscopy,early diagnosis and aggressive treatment to improve prognosis.