Comparison of the clinicopathological features and prognoses of patients with schistosomal and nonschistosomal colorectal cancer

Abstract

Patients with schistosomal colorectal cancer (CRC) and nonschistosomal CRC have different clinicopathological features, laboratory test results and survival rates. Long-term infection with schistosomiasis in patients with CRC may affect the pathogenesis and subsequently change the mechanisms of CRC in these patients, resulting in changes in the survival rates of patients with schistosomal and nonschistosomal CRC. In China, the most common type of schistosomiasis is S. japonicum. The present study aimed to investigate the clinicopathological features and prognostic factors of schistosomal and nonschistosomal CRC. A total of 253 patients with schistosomal CRC and 2,885 patients with nonschistosomal CRC were analyzed and their symptoms, clinicopathological features and laboratory test results were retrospectively evaluated. Patients with CRC in the present study underwent radical resection at The First Affiliated Yijishan Hospital of Wannan Medical College between January 2012 and December 2018. A total of 3,138 patients with CRC were enrolled, 253 of whom were patients with schistosomal CRC. Patients were followed-up to examine differences in the 5-year survival rates between patients with schistosomal and nonschistosomal CRC to determine whether schistosomiasis impacted the prognosis of CRC. There were significant differences in age, sex, fecal occult blood positive, pathological T stage, and CA19-9, WBC, RBC and PLT levels between patients with schistosomal CRC and nonschistosomal CRC. For residents in areas with higher levels of schistosomiasis infections, especially middle-aged and elderly males, serum tumor markers and digestive tract endoscopy should be regularly evaluated to detect the presence of digestive tract tumors as early as possible.

Comparison of non-schistosomal colorectal cancer and schistosomal colorectal cancer

“…The association between schistosomiasis and clinicopathological characteristics was evaluated by using the chi-square and Fisher's exact tests (Table 3). The Qingpu District of Shanghai was previously predominantly rural and, as more males were engaged in farm work, is likely to be at greater risk for exposure [31][32][33].…”

Comparison of non-schistosomal colorectal cancer and schistosomal colorectal cancer

“…Our results showed that there is also a male predominance(61%, Table 1) in the cohort, although there was no signi cant difference between CRC-NS and CRC-S patients (Table 3). Given Qingpu district of Shanghai is previously a countryside, more males engage in farm work, and they may be at greater risk for exposure [31][32][33].…”

Schistosoma mansoni eggs induce Wnt/β-catenin signaling and activate the protooncogene c-Jun in human and hamster colon

“…A recent study has suggested that schistosomal colitis is more commonly associated with an earlier onset of multicentric CRC, high percentage of mucinous adenocarcinoma, and presents at an advanced stage 19 . Another recently published report demonstrated that S. japonicum infection facilitates the development of CRC, particularly in the early and intermediate stages, suggesting that schistosomiasis may alter the mechanisms underlying the progression of CRC 22 . Nevertheless patients with schistosomal and nonschistosomal CRC, had the same outcome after 7.5 years 22 .…”