结直肠癌患者ABO血型与术后病理学特征的关系:基于DACCA的真实世界数据研究

Relation between ABO blood type and postoperative pathological features of patients with colorectal cancer:a real-world study based on DACCA

目的分析当前版本华西肠癌数据库(Database from Colorectal Cancer,DACCA)中结直肠患者的血型与术后临床病理特征的关系。方法本次数据分析选取的DACCA版本为2022年1月5日更新版。根据制定的筛选条件将纳入的结直肠癌患者按血型分为A、B、AB、O型,分析不同血型患者术后病理学特征如病理学TNM、T、N、M(pathological TNM、T、N、M,pTNM、pT、pN、pM)分期、周围神经受累、高危因素、肿瘤退缩分级(tumor regression grade,TRG)及癌结节方面的差异。结果共收集到符合研究条件的数据总量6089条,其中A、B、AB及O血型患者数据分别为2058、1469、494及2068条。统计分析结果发现:①不同血型患者的pTNM、pM分期各期总体分布情况差异均呈现出有统计学意义(H=11.564、P=0.009;H=7.947、P=0.047),其具体体现在:从总体分布趋势看,4种血型患者在同一分期占比均比较接近,但仍可看出,AB血型患者较其他3种血型患者在Ⅲ、Ⅳ、M1a、M1b期中占比最高。②不同血型患者的周围神经损伤、病理TRG总体分布情况未呈现出有统计学意义的差异(H=3.414、P=0.332;H=1.143、P=0.767)。③在不同血型患者中高危因素不同分级占比情况总体比较差异有统计学意义(H=14.540、P=0.002),体现在AB血型患者较其他3种血型患者在高危因素分级3~5级者中占比均最高。④)在不同血型患者中癌结节数量分布占比情况总体比较差异无统计学意义(H=4.460、P=0.216)。结论不同血型结直肠癌患者在pTNM、pM分期及高危因素分级方面存在较明显的差异;不同血型结直肠癌患者的pT、pN分期、周围神经受累、病理TRG及癌结节未表现出明显的差异。血型对结直肠癌患者术后病理学特征的影响还需要再扩大多中心样本深度探究。

Objective To analyze the relation between ABO blood type and postoperative pathological features of patients with colorectal cancer served by West China Hospital of Sichuan University as a regional center in the current version of Database from Colorectal Cancer(DACCA).Methods The data of DACCA was updated on January 5,2022.According to the screening conditions,the enrolled patients with colorectal cancer were divided into blood type A,B,AB,and O.The differences in the postoperative pathological characteristics of patients with different blood types,such as pathological TNM,T,N,M(pTNM,pT,pN,pM)staging,peripheral nerve involvement,high risk factors,tumor regression grade(TRG),and cancer nodules,were analyzed.Results After screening,6089 data rows were analyzed.The patients involved 2058 blood type A,1469 blood type B,494 blood type AB,and 2068 blood type O.The results of statistical analysis showed that:①There were statistical differences in the overall distribution of pTNM and pM stages among the patients with different blood types(H=11.564,P=0.009;H=7.947,P=0.047),which was reflected in:from the overall distribution trend,the proportion of patients with the four blood types in the same stage was similar,but it could still be seen that patients with blood type AB accounted for the highest proportion in the patients with stageⅢ,Ⅳ,M1a,M1b as compared with other blood types.②There were no statistical differences in the overall distribution of peripheral nerve involvement and TRG in the patients with different blood types(H=3.414,P=0.332;H=1.143,P=0.767).③There was statistical difference in the proportion of different grades of high risk factors in the patients with different blood types(H=14.540,P=0.002).Specifically,the proportions of patients with grade 3–5 of high risk factors in the patients with AB blood type were the highest.④There was no statistical difference in the proportion of the grade of cancer nodules number in patients with different blood types(H=4.460,P=0.216).Conclusions From results of this study,it is found that there are some differences in pTNM stage,pM stage,and high risk factors of colorectal cancer patients with different blood types,but no differences in pT stage,pN stage,peripheral nerve involvement,TRG,and cancer nodules among different blood types of patients.The influence of blood type on postoperative pathological characteristics of colorectal cancer patients needs to be further explored.