Characteristics and prognosis of colorectal cancer associated with rheumatic disease.
Characteristics and prognosis of colorectal cancer associated with rheumatic disease.
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DOI：
10.9738/intsurg-d-14-00154.1
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发表时间：
2015-01
影响因子：
0.1
通讯作者：
J. Kishikawa;K. Kawai;N. Tsuno;S. Ishihara;H. Yamaguchi;E. Sunami;Toshiaki Watanabe
中科院分区：
文献类型：
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作者：
J. Kishikawa;K. Kawai;N. Tsuno;S. Ishihara;H. Yamaguchi;E. Sunami;Toshiaki Watanabe
众所周知，宿主免疫在防御结直肠癌（CRC）进展中起着重要作用。免疫系统失调的自身免疫性疾病，如风湿性疾病（RD）对这种免疫的影响尚未得到充分研究。本文回顾性分析了1299例经手术切除的原发性结直肠癌患者的病历。将28例RD患者（RD组）与1271例非RD患者（非RD组）的临床病理因素进行比较。与非RD组相比，RD组以女性居多（P < 0.01），年龄较大（P < 0.01），直肠癌发病率较低（P = 0.02）。虽然在TNM分类方面各组之间没有观察到差异，但在单因素和多因素分析中，RD组的无病生存和总生存均明显较差。患有RD 10年以上的受试者在癌症诊断时淋巴结转移的频率更高（P = 0.06），同步远处转移的发生率明显更高（P = 0.035）。RD与结直肠癌预后明显较差相关，提示自身免疫性疾病对免疫系统的失调可能对宿主对结直肠癌进展的免疫防御产生不利影响。
It is well known that host immunity plays an important role in the defense against colorectal cancer (CRC) progression. The effects of autoimmune diseases, such as rheumatic disease (RD) in which the immune system is deregulated, on this immunity have not been fully investigated. The medical records of 1299 consecutive patients diagnosed with primary colorectal cancer who underwent surgical resection were retrospectively reviewed. The clinicopathologic factors of 28 subjects with RD (RD group) were compared with those of 1271 patients without RD (non-RD group). Compared to the non-RD group, the RD group was typified by a predominance of females (P < 0.01), older age (P < 0.01), and a lower incidence of rectal cancer (P = 0.02). Although no difference was observed between the groups in terms of TNM classification, disease-free and overall survival were significantly poorer in the RD group in both univariate and multivariate analyses. Subjects who had RD for more than 10 years tended to have a higher frequency of lymph node metastasis (P = 0.06) and a significantly higher incidence of synchronous distant metastasis (P = 0.035) at the time of cancer diagnosis. RD was associated with a significantly poorer prognosis of colorectal cancer, suggesting that deregulation of the immune system by autoimmune diseases may adversely affect the host immune defense against colorectal cancer progression.