Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linko, Taiwan.
Colorectal Dis. 2019 Apr;21(4):432-440. doi: 10.1111/codi.14539. Epub 2019 Feb 2.
Whether some diseases are related to the occurrence of synchronous colorectal carcinoma (sCRC) is unknown. Investigating the risk factors and presentation of sCRC could aid in the treatment of patients with colorectal cancer (CRC). The prognosis of sCRC compared with that of solitary CRC remains unclear.
A total of 17 093 CRC patients were recruited between 1st January 1995 and 31th December 2016. The risk factors of sCRC development were assessed using univariate and multivariate logistic regression. The effect of sCRC on survival was analysed using the multivariate Cox regression model.
The prevalence of sCRC was 5.6% in this study. The independent risk factors of sCRC development were advanced age (P < 0.001), male sex (P < 0.001), hereditary cancer (P < 0.001), hypertension (P < 0.001) and liver cirrhosis (P = 0.024). Compared with solitary CRC, a higher number of patients with sCRC presented with an abnormal carcinoembryonic antigen (CEA) level (P = 0.011), anaemia (P < 0.001) and hypoalbuminemia (P < 0.001). Multivariate analysis revealed that sCRC was a significant factor for poor survival in patients at TNM Stage I [hazard ratio (HR) = 1.86; P < 0.001], Stage II (HR = 1.65; P < 0.001) and Stage III (HR = 1.40; P < 0.001).
In addition to hypertension and liver cirrhosis, other risk factors for sCRC were identified in this study. The prognosis of patients with sCRC was significantly worse than that of those with solitary CRC through TNM Stages I to III. Anaemia, abnormal CEA and hypoalbuminemia were more commonly seen in patients with sCRC.
目前尚不清楚某些疾病是否与同时性结直肠癌（sCRC）的发生有关。研究 sCRC 的危险因素和表现有助于治疗结直肠癌（CRC）患者。sCRC 的预后与单发 CRC 的预后相比尚不清楚。
本研究共纳入 1995 年 1 月 1 日至 2016 年 12 月 31 日期间的 17093 例 CRC 患者。使用单因素和多因素逻辑回归评估 sCRC 发生的危险因素。使用多因素 Cox 回归模型分析 sCRC 对生存的影响。
本研究中 sCRC 的患病率为 5.6%。sCRC 发生的独立危险因素为年龄较大（P<0.001）、男性（P<0.001）、遗传性癌症（P<0.001）、高血压（P<0.001）和肝硬化（P=0.024）。与单发 CRC 相比，sCRC 患者有更高比例的异常癌胚抗原（CEA）水平（P=0.011）、贫血（P<0.001）和低白蛋白血症（P<0.001）。多因素分析显示，sCRC 是 TNM Ⅰ期（HR=1.86；P<0.001）、Ⅱ期（HR=1.65；P<0.001）和Ⅲ期（HR=1.40；P<0.001）患者生存不良的显著因素。
除了高血压和肝硬化，本研究还确定了 sCRC 的其他危险因素。通过 TNM 分期Ⅰ至Ⅲ期，sCRC 患者的预后明显差于单发 CRC 患者。贫血、CEA 异常和低白蛋白血症在 sCRC 患者中更为常见。
