A Clinicopathological Comparative Study Of Colorectal Tumors Whose Base Is Located In "Bare Area" Or "Mesenteric Marginal Area"

Objective:The differences of clinicopathological stages and related indexes of patients with primary colorectal cancer located on the"Mesenteric limbus"side and the"bare area"side were compared and analyzed,so as to provide a new reference basis for the clinical diagnosis and treatment of colorectal cancer patients.Method:The clinical data of patients with colorectal cancer from the Gastrointestinal colorectal Anal Surgery Department of China-Japan Friendship Hospital of Jilin University during 2020-2022 were collected and analyzed.A total of 136 patients with complete medical records and feasible surgical treatment and intraoperative pathological specimens could be opened to accurately locate the tumor base were selected for the study.According to relevant studies,the"bare area"and"near mesenteric margin"were defined.The mesenteric margin was the part where vascular nerve lymphatic and other components were concentrated through the intestinal wall,and the"bare area"was defined as the part of vascular nerve lymphatic deficiency on the opposite side of the mesenteric margin.Rectal cancer above peritoneal reflex is located in the same position as colon cancer,and rectal cancer below peritoneal reflex is defined as the mesangial margin of posterior wall tumors below peritoneal reflex,and the tumor base is located in the"naked region"of anterior wall tumors according to the definition of membrane anatomy and embryo transformation.Patients were divided into two groups according to the location of the primary tumor base near the"mesangial border"and near the"bare area",and the data of the two groups were retrospectively analyzedResults:1.Chi-square test showed that there was no significant difference in age composition between the base of the primary tumor located in the Mesenteric limbusal area and the bare area(X~2=0.047,P=0.829).By chi-square test,there was no significant difference in gender composition between the base of the primary tumor located in the Mesenteric limbusal area and the bare area(X~2=0.073,P=0.787).2.According to the exact probability analysis of Fisher,there was no significant statistical significance in the diagnosis of colorectal cancer between the near"Mesenteric limbus"group and the near"naked area"group.3.Through the analysis of the data of the patients included in the study,it can be concluded that there is no significant difference in T staging between the near"Mesenteric limbus"group and the near"bare area"group(P=0.753>0.05),but in the N staging,there is a significant statistical difference between the near"Mesenteric limbus"group and the near"bare area"group(P<0.031<0.05).The N stage in the near"Mesenteric limbus"group was significantly later than that in the near"Mesenteric limbus"group.In M staging,there was a significant difference in M staging between the near"Mesenteric limbus"group and the near"bare area"group(P=0.037<0.05).The proportion of M1 staging in the near"Mesenteric limbus"group was much higher than that in the near"bare area"group.4.According to the statistical study of the existing clinical data in this paper,there was a significant statistical difference in vascular nerve invasion between the near"Mesenteric limbus"group and the near"bare area"group(P=0.013<0.05).5.The related data were outputted by rank sum test.The statistical results showed that Z=﹣0.901,P=0.368.It can be seen that P>0.05,it can not be considered that there is a significant difference in the maximum diameter of tumor between the group near"Mesenteric limbus"and the group near"naked area".6.There was a significant difference in the preoperative carcinoembryonic antigen(CEA)between the"Mesangial margin"group and the near"bare area"group(P=0.000016<0.05).Based on the statistical analysis of the common evaluation indexes of other tumor markers of colorectal cancer,the results are as follows:there is no significant difference in whether the preoperative carbohydrate antigen 19-9(CA19-9)is higher than the normal value between the patients near the"Mesangial margin"and the patients near the"bare area"(P=0.156>0.05).There was no significant difference in preoperative carbohydrate antigen 125(CA125)between the near"Mesangial margin"group and the near"bare area"group(P=1.00>0.05),but there was significant statistical difference between the near"Mesangial margin"group and the near"bare area"group(P=0.014<0.05).Conclusions:1.Preoperative positive rates of CEA,CA242 and other tumor markers near the mesangial margin of colorectal cancer were significantly higher than those near the"bare area".2.The rate of lymph node metastasis(N),the rate of distant metastasis(M),and the positive rate of vascular or nerve invasion near the"mesangial border"were significantly higher in colorectal cancer region,but there was no significant difference between the"mesangial border"and the"bare area"near the depth of tumor invasion(T).3.There is no significant difference in the gender,age of onset,specific diagnosis of anatomical location and maximum diameter of the tumor between the proximal"mesangial"side and the proximal"bare"side.