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, 朱小宝. 结直肠癌与JC病毒的相关研究展望. 结直肠肛门外科, 2012, 18 (2): 143-146.
2.	王锡山. 从ESMO共识看结直肠癌肝转移的治疗策略. 中华结直肠疾病电子杂志, 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, 蔡世荣, 等. 结直肠癌伴腹膜扩散的临床病理分析及手术干预对预后的影响. 中华外科杂志, 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, 蔡世荣, 等. 结直肠黏液腺癌的临床特点. 中华胃肠外科杂志, 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.	刘峰, 余江, 梁耀泽, 等. 结直肠癌腹膜种植转移的危险因素分析. 中华胃肠外科杂志, 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.	田满福, 韩波. 检测CA199、CA125、CA153及CEA在肿瘤诊断中的意义. 临床和实验医学杂志, 2010, 9(7): 483-485.
28.	何振华, 张森, 宋现青, 等. 结直肠癌腹膜种植转移的相关因素分析. 中国肿瘤临床, 2013, 40(2): 107-110.
29.	荆结线, 杜丽莉, 王文达, 等. 结直肠癌患者血清肿瘤标志物水平与临床病理学特征的关系. 中国肿瘤临床, 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.	杨琳, 郭宝文, 赵魁. IGF-Ⅰ、IGF-Ⅱ在大肠癌中的表达及临床意义. 山东医药, 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, 朱小宝. 结直肠癌与JC病毒的相关研究展望. 结直肠肛门外科, 2012, 18 (2): 143-146.
2. 王锡山. 从ESMO共识看结直肠癌肝转移的治疗策略. 中华结直肠疾病电子杂志, 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, 蔡世荣, 等. 结直肠癌伴腹膜扩散的临床病理分析及手术干预对预后的影响. 中华外科杂志, 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, 蔡世荣, 等. 结直肠黏液腺癌的临床特点. 中华胃肠外科杂志, 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. 刘峰, 余江, 梁耀泽, 等. 结直肠癌腹膜种植转移的危险因素分析. 中华胃肠外科杂志, 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. 田满福, 韩波. 检测CA199、CA125、CA153及CEA在肿瘤诊断中的意义. 临床和实验医学杂志, 2010, 9(7): 483-485.
28. 何振华, 张森, 宋现青, 等. 结直肠癌腹膜种植转移的相关因素分析. 中国肿瘤临床, 2013, 40(2): 107-110.
29. 荆结线, 杜丽莉, 王文达, 等. 结直肠癌患者血清肿瘤标志物水平与临床病理学特征的关系. 中国肿瘤临床, 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. 杨琳, 郭宝文, 赵魁. IGF-Ⅰ、IGF-Ⅱ在大肠癌中的表达及临床意义. 山东医药, 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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