关键词: 结直肠癌, 嗜神经侵袭, 切除手术, 预后

Abstract: Objective To investigate the status of neurotropic invasion (PNI) in patients with colorectal cancer resection and its correlation with prognosis.Methods A total of 200 patients who underwent colorectal cancer resection in our hospital from September 2018 to August 2019 were prospectively selected as research objects,and divided into PNI group and no PNI group according to whether PNI occurred.The general data such as clinical characteristics and condition of the two groups were compared,and the postoperative overall survival time (OS) of all patients was recorded to evaluate the prognosis.The Kaplan-Meier method was used to analyze the prognosis of patients with different characteristics;Cox regression was used to analyze the prognostic factors of colorectal cancer patients after resection.Results Among the 200 patients,39 (19.50%) had PNI and were classified as PNI group,and the remaining 161 patients were classified as non-PNI group;Compared with non-PNI group,the tumor diameter in PNI group was larger,the proportion of T stage T3 to T4,the proportion of metastatic lymph nodes and the proportion of postoperative adjuvant therapy were higher (P<0.05);Kaplan-Meier curve showed that the 3-year overall survival time of patients with pathological stages T3 to T4 was significantly lower than that of patients with pathological stages T1 to T2 (Log-rankχ2=3.936,P=0.047).The 3-year overall survival of PNI positive patients was significantly lower than that of PNI negative patients (Log-rankχ2=10.629,P<0.001).The 3-year overall survival time after adjuvant treatment was significantly higher than that without adjuvant treatment (Log-rankχ2=8.362,P=0.003).The 3-year overall survival of PNI positive patients was significantly higher than that of PNI negative patients (Logrankχ2=28.824,P<0.001).Without adjuvant treatment,the 3year overall survival time of PNI-negative patients was significantly higher than that of PNI-positive patients (Logrankχ2=6.509,P=0.011).Cox multivariate regression analysis showed that:T3~T4 (HR=3.228,95%CI 1.813~5.747),proportion of metastatic lymph nodes (HR=3.304,95%CI 1.996~5.469),large tumor diameter (HR=2.571,95%CI 1.161~5.694),positive PNI (HR=2.792,95%CI 1.669~4.669) was a risk factor for prognosis after colorectal cancer resection (all P<0.05).Conclusion PNI phenomenon exists in patients undergoing colorectal cancer resection,and PNI is related to prognosis.

Key words: colorectal cancer, neurotropic invasion, excision surgery, prognosis