Multivariate Analysis of Risk Factors of Simultaneity Peritoneal Metastasis of Colorectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHUXin-qiang ^1,2 ,  GUANWen-xian ²

1. 1.Department of General Surgery, Suqian People’s Hospital, Nanjing Drum Tower Hospital Group of Nanjing University Medical School, Suqian 223800, Jiangsu Province, China;
2. 2.Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China;

Corresponding?author：

GUANWen-xian, Email: 15850502391@163.com

Keywords：

Colorectal cancer; Peritoneal metastasis; Influence factor

DOI：

10.7507/1007-9424.20160185

Video：

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Objective To investigate the clinical and pathological factors associated with simultaneity peritoneal metastasis of colorectal cancer. Methods Clinical data of 1 593 patients with simultaneity peritoneal metastasis of colorectal cancer who treated in Suqian People’s Hospital and Nanjing Drum Tower Hospital from 2010-2014 were collected to analyze the risk factors of simultaneity peritoneal metastasis of colorectal cancer. Results There were 40 patients (2.5%) suffered form simultaneity peritoneal metastasis of the 1 593 patients with colorectal cancer. The result of univariate analysis showed that, age, diameter of tumor, level of carcino-embryonic antigen (CEA), level of CA19-9, level of CA-125, T staging, differentiation, pathological type, and combining with diabetes were risk factors of simultaneity peritoneal metastasis of colorectal cancer, that incidence rates of simultaneity peritoneal metastasis in patients with ≥ 65 years old, diameter ≥ 5 cm, increase of CEA, CA19-9, and CA-125, later staging of T staging, poorly differentiated, signet ring cell carcinoma/mucinous adenocarcinoma, and combining with diabetes were higher (P<0.05). The result of logistic regression showed that, level of CA19-9, level of CA-125, T staging, combining with diabetes, differentiation, and pathological type were the risk factors of simultaneity peritoneal metastasis of colorectal cancer, that incidence rates of simultaneity peritoneal metastasis in patients with increase of CEA and CA-125, later staging of T staging, poorly differentiated (compared with well differentiated), mucinous adenocarcinoma (compared with adenocarcinoma), and combining with diabetes were higher (P<0.05). Conclusion Increase of CEA and CA-125, T staging, poorly differentiated, mucinous adenocarcinoma, and combining with diabetes are independent risk factors for simultaneity peritoneal metastasis of colorectal cancer.

Citation： ZHUXin-qiang, GUANWen-xian. Multivariate Analysis of Risk Factors of Simultaneity Peritoneal Metastasis of Colorectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(6): 696-701. doi: 10.7507/1007-9424.20160185 Copy

1.	宋永攀, 田小林, 朱小寶. 結直腸癌與JC病毒的相關研究展望. 結直腸肛門外科, 2012, 18 (2): 143-146.
2.	王錫山. 從ESMO共識看結直腸癌肝轉移的治療策略. 中華結直腸疾病電子雜志, 2014, 3(1): 9-11.
3.	Yawar B, Babar S, Imaad-Ur-Rehman, et al . Multidetector CT patterns of peritoneal involvement in patients with abdominopelvic malignancies. J Coll Physicians Surg Pak , 2015, 25(6): 399-402.
4.	Segelman J, Granath F, Holm T, et al . Incidence, prevalence and risk factors for peritoneal carcinomatosis from colorectal cancer. Br J Surg , 2012, 99(5): 699-705.
5.	Lemmens VE, Klaver YL, Verwaal VJ, et al . Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin: a population-based study. Int J Cancer , 2011, 128(11): 2717-2725.
6.	Sjo OH, Berg M, Merok MA, et al . Peritoneal carcinomatosis of colon cancer origin: highest incidence in women and in patients with right-sided tumors. J Surg Oncol , 2011, 104(7): 792-797.
7.	Kojima M, Higuchi Y, Yokota M, et al . Human subperitoneal fibroblast and cancer cell interaction creates microenvironment that enhances tumor progression and metastasis. PLoS One , 2014, 9(2): e88018.
8.	Sugarbaker PH. Colorectal cancer: prevention and management of metastatic disease. Biomed Res Int , 2014, 2014: 782890.
9.	Kobayashi H, Kotake K, Sugihara K. Enhancing the objectivity of the Japanese classification of peritoneal metastases from colorectal cancer. Jpn J Clin Oncol , 2014, 44(10): 898-902.
10.	Akagi Y, Kinugasa T, Adachi Y, et al . Prognostic significance of isolated tumor cells in patients with colorectal cancer in recent 10-year studies. Mol Clin Oncol , 2013, 1(4): 582-592.
11.	Yang SH, Lin JK, Lai CR, et al . Risk factors for peritoneal dissemination of colorectal cancer. J Surg Oncol , 2004, 87(4): 167-173.
12.
13.	Saluja S, Alatise OI, Adewale A, et al . A comparison of colorectal cancer in Nigerian and North American patients: is the cancer biology different?. Surgery , 2014, 156(2): 305-310.
14.	Jun KH, Jung H, Baek JM, et al . Does tumor size have an impact on gastric cancer? A single institute experience. Langenbecks Arch Surg , 2009, 394(4): 631-635.
15.	宋武, 何裕隆, 蔡世榮, 等. 結直腸癌伴腹膜擴散的臨床病理分析及手術干預對預后的影響. 中華外科雜志, 2008, 46(21): 1634-1637.
16.	Tanaka T, Kumagai K, Shimizu K, et al . Peritoneal metastasis in gastric cancer with particular reference to lymphatic advancement; extranodal invasion is a significant risk factor for peritoneal metastasis. J Surg Oncol , 2000, 75(3): 165-171.
17.	de Ridder JA, Knijn N, Wiering B, et al . Lymphatic invasion is an independent adverse prognostic factor in patients with colorectal liver metastasis. Ann Surg Oncol , 2015, 22 Suppl 3: 638-645.
18.	Benedix F, Kuester D, Meyer F, et al . Influence of mucinous and signet-ring cell differentiation on epidemiological, histological, molecular biological features, and outcome in patients with colorectal carcinoma. Zentralbl Chir , 2013, 138(4): 427-433.
19.	宋武, 何裕隆, 蔡世榮, 等. 結直腸黏液腺癌的臨床特點. 中華胃腸外科雜志, 2009, 5(12): 487-490.
20.	Passot G, Mohkam K, Cotte E, et al . Intra-operative peritoneal lavage for colorectal cancer. World J Gastroenterol , 2014, 20(8): 1935-1939.
21.	Baskaranathan S, Philips J, McCredden P, et al . Free colorectal cancer cells on the peritoneal surface: correlation with pathologic variables and survival. Dis Colon Rectum , 2004, 47(12): 2076-2079.
22.	Wu XZ, Ma F, Wang XL. Serological diagnostic factors for liver metastasis in patients with colorectal cancer. World J Gastroenterol , 2010, 16(32): 4084-4088.
23.	Yu H, Son GM, Joh YG. The clinical significance of preoperative serum levels of carbohydrate antigen 19-9 in colorectal cancer. J Korean Surg Soc , 2013, 84(4): 231-237.
24.	劉峰, 余江, 梁耀澤, 等. 結直腸癌腹膜種植轉移的危險因素分析. 中華胃腸外科雜志, 2011, 14(4): 254-256.
25.	Zhu X, Zhou W, Chen Y, et al . High serum carbohydrate antigen 125 concentration can predict serous effusion but not gastrointestinal malignancy in male patients. Tumour Biol , 2014, 35(6): 5129-5135.
26.	Kabawat SE, Bast RC Jr, Bhan AK, et al . Tissue distribution of a coelomic-epithelium-related antigen recognized by the monoclonal antibody OC125. Int J Gynecol Pathol , 1983, 2(3): 275-285.
27.	田滿福, 韓波. 檢測CA199、CA125、CA153及CEA在腫瘤診斷中的意義. 臨床和實驗醫學雜志, 2010, 9(7): 483-485.
28.	何振華, 張森, 宋現青, 等. 結直腸癌腹膜種植轉移的相關因素分析. 中國腫瘤臨床, 2013, 40(2): 107-110.
29.	荊結線, 杜麗莉, 王文達, 等. 結直腸癌患者血清腫瘤標志物水平與臨床病理學特征的關系. 中國腫瘤臨床, 2008, 35(3): 162-166.
30.	Luo S, Li JY, Zhao LN, et al . Diabetes mellitus increases the risk of colorectal neoplasia: an updated meta-analysis. Clin Res Hepatol Gastroenterol , 2016, 40(1): 110-123.
31.	Reinmuth N, Fan F, Liu W, et al . Impact of insulin-like growth factor receptor-Ⅰ function on angiogenesis, growth, and metastasis of colon cancer. Lab Invest , 2002, 82(10): 1377-1389.
32.	楊琳, 郭寶文, 趙魁. IGF-Ⅰ、IGF-Ⅱ在大腸癌中的表達及臨床意義. 山東醫藥, 2005, 45(9): 35-36.
33.	Sharma A, Ng H, Kumar A, et al . Colorectal cancer: histopathologic differences in tumor characteristics between patients with and without diabetes. Clin Colorectal Cancer , 2014, 13(1): 54-61.
34.	Weber MM, Fottner C, Liu SB, et al . Overexpression of the insulin-like growth factorⅠreceptor in human colon carcinomas. Cancer , 2002, 95(10): 2086-2095.
35.	Vinikoor LC, Galanko JA, Sandler RS. Cholecystectomy and the risk of colorectal adenomas. Dig Dis Sci , 2008, 53(3): 730-735.
36.	Adami HO, Meirik O, Gustavsson S, et al . Colorectal cancer after cholecystectomy: absence of risk increase within 11-14 years. Gastroenterology , 1983, 85(4): 859-865.
37.	de Bree E, Koops W, Kroger R, et al . Peritoneal carcinomatosis from colorectal or appendiceal origin: correlation of preoperative CT with intraoperative findings and evaluation of interobserver agreement. J Surg Oncol , 2004, 86(2): 64-73.

1. 宋永攀, 田小林, 朱小寶. 結直腸癌與JC病毒的相關研究展望. 結直腸肛門外科, 2012, 18 (2): 143-146.
2. 王錫山. 從ESMO共識看結直腸癌肝轉移的治療策略. 中華結直腸疾病電子雜志, 2014, 3(1): 9-11.
3. Yawar B, Babar S, Imaad-Ur-Rehman, et al . Multidetector CT patterns of peritoneal involvement in patients with abdominopelvic malignancies. J Coll Physicians Surg Pak , 2015, 25(6): 399-402.
4. Segelman J, Granath F, Holm T, et al . Incidence, prevalence and risk factors for peritoneal carcinomatosis from colorectal cancer. Br J Surg , 2012, 99(5): 699-705.
5. Lemmens VE, Klaver YL, Verwaal VJ, et al . Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin: a population-based study. Int J Cancer , 2011, 128(11): 2717-2725.
6. Sjo OH, Berg M, Merok MA, et al . Peritoneal carcinomatosis of colon cancer origin: highest incidence in women and in patients with right-sided tumors. J Surg Oncol , 2011, 104(7): 792-797.
7. Kojima M, Higuchi Y, Yokota M, et al . Human subperitoneal fibroblast and cancer cell interaction creates microenvironment that enhances tumor progression and metastasis. PLoS One , 2014, 9(2): e88018.
8. Sugarbaker PH. Colorectal cancer: prevention and management of metastatic disease. Biomed Res Int , 2014, 2014: 782890.
9. Kobayashi H, Kotake K, Sugihara K. Enhancing the objectivity of the Japanese classification of peritoneal metastases from colorectal cancer. Jpn J Clin Oncol , 2014, 44(10): 898-902.
10. Akagi Y, Kinugasa T, Adachi Y, et al . Prognostic significance of isolated tumor cells in patients with colorectal cancer in recent 10-year studies. Mol Clin Oncol , 2013, 1(4): 582-592.
11. Yang SH, Lin JK, Lai CR, et al . Risk factors for peritoneal dissemination of colorectal cancer. J Surg Oncol , 2004, 87(4): 167-173.
12.
13. Saluja S, Alatise OI, Adewale A, et al . A comparison of colorectal cancer in Nigerian and North American patients: is the cancer biology different?. Surgery , 2014, 156(2): 305-310.
14. Jun KH, Jung H, Baek JM, et al . Does tumor size have an impact on gastric cancer? A single institute experience. Langenbecks Arch Surg , 2009, 394(4): 631-635.
15. 宋武, 何裕隆, 蔡世榮, 等. 結直腸癌伴腹膜擴散的臨床病理分析及手術干預對預后的影響. 中華外科雜志, 2008, 46(21): 1634-1637.
16. Tanaka T, Kumagai K, Shimizu K, et al . Peritoneal metastasis in gastric cancer with particular reference to lymphatic advancement; extranodal invasion is a significant risk factor for peritoneal metastasis. J Surg Oncol , 2000, 75(3): 165-171.
17. de Ridder JA, Knijn N, Wiering B, et al . Lymphatic invasion is an independent adverse prognostic factor in patients with colorectal liver metastasis. Ann Surg Oncol , 2015, 22 Suppl 3: 638-645.
18. Benedix F, Kuester D, Meyer F, et al . Influence of mucinous and signet-ring cell differentiation on epidemiological, histological, molecular biological features, and outcome in patients with colorectal carcinoma. Zentralbl Chir , 2013, 138(4): 427-433.
19. 宋武, 何裕隆, 蔡世榮, 等. 結直腸黏液腺癌的臨床特點. 中華胃腸外科雜志, 2009, 5(12): 487-490.
20. Passot G, Mohkam K, Cotte E, et al . Intra-operative peritoneal lavage for colorectal cancer. World J Gastroenterol , 2014, 20(8): 1935-1939.
21. Baskaranathan S, Philips J, McCredden P, et al . Free colorectal cancer cells on the peritoneal surface: correlation with pathologic variables and survival. Dis Colon Rectum , 2004, 47(12): 2076-2079.
22. Wu XZ, Ma F, Wang XL. Serological diagnostic factors for liver metastasis in patients with colorectal cancer. World J Gastroenterol , 2010, 16(32): 4084-4088.
23. Yu H, Son GM, Joh YG. The clinical significance of preoperative serum levels of carbohydrate antigen 19-9 in colorectal cancer. J Korean Surg Soc , 2013, 84(4): 231-237.
24. 劉峰, 余江, 梁耀澤, 等. 結直腸癌腹膜種植轉移的危險因素分析. 中華胃腸外科雜志, 2011, 14(4): 254-256.
25. Zhu X, Zhou W, Chen Y, et al . High serum carbohydrate antigen 125 concentration can predict serous effusion but not gastrointestinal malignancy in male patients. Tumour Biol , 2014, 35(6): 5129-5135.
26. Kabawat SE, Bast RC Jr, Bhan AK, et al . Tissue distribution of a coelomic-epithelium-related antigen recognized by the monoclonal antibody OC125. Int J Gynecol Pathol , 1983, 2(3): 275-285.
27. 田滿福, 韓波. 檢測CA199、CA125、CA153及CEA在腫瘤診斷中的意義. 臨床和實驗醫學雜志, 2010, 9(7): 483-485.
28. 何振華, 張森, 宋現青, 等. 結直腸癌腹膜種植轉移的相關因素分析. 中國腫瘤臨床, 2013, 40(2): 107-110.
29. 荊結線, 杜麗莉, 王文達, 等. 結直腸癌患者血清腫瘤標志物水平與臨床病理學特征的關系. 中國腫瘤臨床, 2008, 35(3): 162-166.
30. Luo S, Li JY, Zhao LN, et al . Diabetes mellitus increases the risk of colorectal neoplasia: an updated meta-analysis. Clin Res Hepatol Gastroenterol , 2016, 40(1): 110-123.
31. Reinmuth N, Fan F, Liu W, et al . Impact of insulin-like growth factor receptor-Ⅰ function on angiogenesis, growth, and metastasis of colon cancer. Lab Invest , 2002, 82(10): 1377-1389.
32. 楊琳, 郭寶文, 趙魁. IGF-Ⅰ、IGF-Ⅱ在大腸癌中的表達及臨床意義. 山東醫藥, 2005, 45(9): 35-36.
33. Sharma A, Ng H, Kumar A, et al . Colorectal cancer: histopathologic differences in tumor characteristics between patients with and without diabetes. Clin Colorectal Cancer , 2014, 13(1): 54-61.
34. Weber MM, Fottner C, Liu SB, et al . Overexpression of the insulin-like growth factorⅠreceptor in human colon carcinomas. Cancer , 2002, 95(10): 2086-2095.
35. Vinikoor LC, Galanko JA, Sandler RS. Cholecystectomy and the risk of colorectal adenomas. Dig Dis Sci , 2008, 53(3): 730-735.
36. Adami HO, Meirik O, Gustavsson S, et al . Colorectal cancer after cholecystectomy: absence of risk increase within 11-14 years. Gastroenterology , 1983, 85(4): 859-865.
37. de Bree E, Koops W, Kroger R, et al . Peritoneal carcinomatosis from colorectal or appendiceal origin: correlation of preoperative CT with intraoperative findings and evaluation of interobserver agreement. J Surg Oncol , 2004, 86(2): 64-73.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Multivariate Analysis of Risk Factors of Simultaneity Peritoneal Metastasis of Colorectal Cancer

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