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©The Author(s) 2016.
World J Gastroenterol. Feb 28, 2016; 22(8): 2576-2584
Published online Feb 28, 2016. doi: 10.3748/wjg.v22.i8.2576
Published online Feb 28, 2016. doi: 10.3748/wjg.v22.i8.2576
Table 1 Basic characteristics of 469 rectal adenocarcinoma patients n (%)
Characteristic | Total patients (n = 469)1 | RAC patients with LNM(n = 231)1 | RAC patients without LNM (n = 238)1 | P value |
Male sex | 286 (61.0) | 146 (63.2) | 140 (58.8) | 0.331 |
Mean age, yr | 62.1 ± 12.6 | 60.6 ± 12.8 | 63.6 ± 12.2 | 0.012 |
BMI3, kg/m2 | 23.95 ± 3.54 | 23.90 ±3.67 | 24.0 ± 3.41 | 0.779 |
Hypertension | 131 (27.9) | 58 (25.1) | 73 (30.7) | 0.179 |
Alcohol intake | 29 (6.2) | 18 (7.8) | 11 (4.6) | 0.154 |
Smoking | 129 (27.5) | 55 (23.8) | 74 (31.1) | 0.077 |
White blood cell, × 109/L | 6.66 ± 2.10 | 6.70 ± 2.09 | 6.61 ± 2.11 | 0.666 |
Hemoglobin, g/L | 132 ± 20 | 131 ± 20 | 132 ± 19 | 0.553 |
Platelet count, × 109/L | 233 ± 79 | 235 ± 74 | 232 ± 84 | 0.659 |
Total bilirubin2, mmol/L | 10.26 (7.70-14.40) | 10.26 (7.40-15.0) | 10.26 (8.13-13.68) | 0.451 |
Direct bilirubin2, mmol/L | 2.30 (1.60-3.42) | 2.50 (1.70-3.42) | 2.10 (1.40-3.42) | 0.025 |
ALT2, U/L | 16 (12-22) | 15 (12-22) | 16 (12-22) | 0.262 |
AST2, U/L | 19 (16-23) | 18 (15-22) | 19 (16-24) | 0.076 |
ALP2, U/L | 66 (55-81) | 66 (54-82) | 66 (55-80) | 0.905 |
GGT2, U/L | 17 (13-25) | 18 (13-26) | 16 (12-23) | 0.136 |
Serum cholinesterase4, U/L | 161.3 ± 50.0 | 158.1 ± 50.1 | 164.5 ± 50.0 | 0.170 |
Total bile acid2, μmol/L | 4.4 (2.4-7.3) | 4.5 (2.4-8.5) | 4.2 (2.5-7.1) | 0.546 |
Prothrombin time5, s | 13.2 ± 1.4 | 13.2 ± 1.7 | 13.2 ± 1.1 | 0.651 |
International normalized ratio/INR5 | 1.02 ± 0.14 | 1.02 ± 0.17 | 1.01 ± 0.11 | 0.313 |
Albumin level6, g/L | 42.3 ± 4.5 | 42.3 ± 4.4 | 42.2 ± 4.6 | 0.908 |
Creatinine, mg/dL | 82.1 ± 18.0 | 80.8 ± 15.5 | 83.3 ± 20.1 | 0.128 |
Serum sodium7, mmol/L | 141.0 ± 3.0 | 141.0 ± 3.1 | 142.0 ± 2.9 | 0.028 |
Serum potassium7, mmol/L | 4.1 ± 0.5 | 4.1 ± 0.4 | 4.1 ± 0.5 | 0.282 |
Carcinoembryonic antigen28, ng/mL | 4.33 (2.22-11.91) | 5.40 (2.40-13.95) | 3.50 (2.08-8.67) | 0.009 |
Serum CA19-929, kU/L | 14.02 (7.20-28.63) | 15.10 (7.39-33.91) | 13.41 (7.10-23.10) | 0.109 |
Table 2 Pathological characteristics and follow-up results of 469 rectal adenocarcinoma patients n (%)
Characteristic | Total patient s(n = 469)1 | RAC patients with LNM (n = 231)1 | RAC patients without LNM (n = 238)1 | P value |
Pathological lymph node stage | < 0.001 | |||
pN0 | 238 (50.7) | 0 (0.0) | 238 (100.0) | - |
pN1 | 136 (29.0) | 136 (58.9) | 0 (0.0) | - |
pN2 | 95 (20.3) | 95 (41.1) | 0 (0.0) | - |
Pathological tumor classification (pT) | < 0.001 | |||
pT1 | 18 (3.8) | 1 (0.4) | 17 (7.1) | - |
pT2 | 90 (19.2) | 21 (9.1) | 69 (29.0) | - |
pT3 | 118 (25.2) | 54 (23.4) | 64 (26.9) | - |
pT4 | 243 (51.8) | 155 (67.1) | 88 (37.0) | - |
Pathological distant metastasis (pM) | ||||
pM0 | 439 (93.6) | 213 (92.2) | 226 (95.0) | 0.224 |
pM1 | 30 (6.4) | 18 (7.8) | 12 (5.0) | - |
Tumor differentiation | ||||
Moderately/well | 388 (82.7) | 166 (71.9) | 222 (93.3) | < 0.001 |
Poorly | 57 (12.2) | 46 (19.9) | 11 (4.6) | - |
Unknown | 24 (5.1) | 19 (8.2) | 5 (2.1) | - |
Number of lymph node | ||||
Lymph node-positive (metastasis) | 2.2 ± 4.5 | 4.5 ± 5.5 | - | - |
Total number of lymph node removal | 13.3 ± 8.4 | 15.0 ± 9.1 | 11.6 ± 7.3 | < 0.001 |
Results of follow-up | ||||
Death | 72 (15.4) | 46 (19.9) | 26 (10.9) | 0.007 |
Survival | 277 (59.1) | 118 (51.1) | 159 (66.8) | 0.001 |
Lost | 120 (25.6) | 67 (29.0) | 53 (22.3) | 0.095 |
Time of follow-up2 (mo) | 24.0 (9.0-44.3) | 20 (9.0-37.9) | 29.1 (10.5-48.5) | 0.013 |
Table 3 Multivariate analysis: significance of increased serum direct bilirubin for rectal cancer patients with lymph node metastasis
Variable | Adjusted OR | 95%CI | P value |
Direct bilirubin ≥ 2.60 μmol/L | 1.602 | 1.098-2.338 | 0.015 |
Age < 60 yr | 1.851 | 1.259-2.724 | 0.002 |
Serum sodium ≤ 141 mmol/L | - | - | 0.090 |
Table 4 Association between increased serum direct bilirubin level and clinicopathological data n (%)
Variable | Direct bilirubin≥2.60μmol/L | Direct bilirubin < 2.60μmol/L | P value |
Gender | |||
Male | 148 (70.5) | 138 (53.3) | < 0.001 |
Female | 62 (29.5) | 121 (46.7) | - |
Age, yr | |||
< 60 | 79 (37.6) | 102 (39.4) | 0.697 |
≥ 60 | 131 (62.4) | 157 (60.6) | - |
Serum sodium, mmol/L | |||
≤ 141 | 101 (49.5) | 142 (56.1) | 0.159 |
> 141 | 103 (50.5) | 111 (43.9) | - |
Carcinoembryonic antigen, ng/mL | |||
< 5.0 | 85 (50.0) | 129 (58.1) | 0.110 |
≥ 5.0 | 85 (50.0) | 93 (41.9) | - |
Tumor differentiation | |||
Moderately/well | 171 (86.8) | 217 (87.5) | 0.827 |
Poorly | 26 (13.2) | 31 (12.5) | - |
Pathological tumor classification (pT) | |||
pT1/ pT2 | 39 (18.6) | 69 (26.6) | 0.039 |
pT3/ pT4 | 171 (81.4) | 190 (73.4) | - |
Pathological lymph node stage (pN) | |||
pN1 | 65 (57.0) | 71 (60.7) | 0.571 |
pN2 | 49 (43.0) | 46 (39.3) | - |
Pathological distant metastasis (pM) | |||
pM0 | 200 (95.2) | 239 (92.3) | 0.193 |
pM1 | 10 (4.8) | 20 (7.7) | - |
Table 5 Association between concentrations of increased serum direct bilirubin and lymph node metastasis n (%)
Direct bilirubin/DBil (μmol/L) | Patients with LNM | Patients without LNM | OR (95%CI) | P value |
DBil ≤ 1.50 | 50 (43.1) | 66 (56.9) | 1 (reference) | - |
1.50 < DBil ≤ 2.50 | 67 (46.9) | 76 (53.1) | 1.164 (0.711-1.905) | 0.547 |
2.50 < DBil ≤ 3.50 | 60 (50.4) | 59 (49.6) | 1.342 (0.803-2.244) | 0.261 |
DBil > 3.50 | 54 (59.3) | 37 (40.7) | 1.926 (1.104-3.362) | 0.020 |
- Citation: Gao C, Fang L, Li JT, Zhao HC. Significance and prognostic value of increased serum direct bilirubin level for lymph node metastasis in Chinese rectal cancer patients. World J Gastroenterol 2016; 22(8): 2576-2584
- URL: https://www.wjgnet.com/1007-9327/full/v22/i8/2576.htm
- DOI: https://dx.doi.org/10.3748/wjg.v22.i8.2576