Original Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jun 21, 2012; 18(23): 2948-2955
Published online Jun 21, 2012. doi: 10.3748/wjg.v18.i23.2948
Pyogenic liver abscesses associated with nonmetastatic colorectal cancers: An increasing problem in Eastern Asia
Kai Qu, Chang Liu, Zhi-Xin Wang, Feng Tian, Ji-Chao Wei, Ming-Hui Tai, Lei Zhou, Fan-Di Meng, Rui-Tao Wang, Xin-Sen Xu
Kai Qu, Chang Liu, Zhi-Xin Wang, Feng Tian, Ji-Chao Wei, Ming-Hui Tai, Lei Zhou, Fan-Di Meng, Rui-Tao Wang, Xin-Sen Xu, Department of Hepatobiliary Surgery, First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: Qu K and Liu C designed the research; Qu K and Wang ZX performed the majority of experiments; Qu K, Tian F, Wei JC and Tai MH provided analytical tools; Qu K, Zhou L, Meng FD and Wang RT analyzed the data; Qu K and Xu XS were involved in editing the manuscript.
Supported by The National Natural Science Foundation of China, No. 30872482 and No. 81072051
Correspondence to: Chang Liu, Professor, Department of Hepatobiliary Surgery, First Affiliated Hospital, School of Medicine, Xi’an Jiaotong University, No.277 West Yan-ta Road, Xi’an 710061, Shaanxi Province, China. liuchangdoctor@163.com
Telephone: +86-29-82653900 Fax: +86-29-82653905
Received: October 19, 2011
Revised: December 15, 2011
Accepted: March 10, 2012
Published online: June 21, 2012
Abstract

AIM: To elaborate the clinicopathologic features of colorectal cancer-related pyogenic liver abscess (PLA).

METHODS: Reported cases of colorectal cancer-related PLAs were collected from the literature published up to October 2011 and evaluated for their clinicopathologic features. Data of collected cases included demographics, clinical presentation, microbial findings and treatment. Categorical variables were compared by χ2 analysis and continuous variables were evaluated using Student’s t test.

RESULTS: A total 96 cases of colorectal cancer-related PLA were collected from the previous literature. Most patients (60%) were male and 40% cases occurred in the age group of 61-70 years. Apart from some special types of PLA, there were significant differences in the microbiological spectrum between Eastern Asia and non-Eastern Asian countries, which implied different risk factors and courses of the disease. Gram negative bacteria especially Klebsiella pneumoniae (K. pneumoniae) PLA was predominant in Eastern Asia (80.0%) in contrast to non-Eastern Asian countries (P < 0.01). Meanwhile, most of the Eastern Asian patients exhibited smaller size of liver abscess and atypical presentation. Sigmoid colon and rectum (72.73%) were the main sites of tumor in Eastern Asian patients, whereas tumor sites were uneven among most of the non-Easter Asian PLA patients.

CONCLUSION: K. pneumoniae PLA was strongly associated with colorectal cancer, especially those occurring in sigmoid colon and rectum, in elderly Eastern Asian male patients.

Keywords: Colorectal cancer; Pyogenic liver abscess; Etiology; Microbiology; Treatment