Self-expanding metal stent placement and pathological alterations among obstructive colorectal cancer cases

作     者：Keisuke Kosumi Kosuke Mima Kosuke Kanemitsu Takuya Tajiri Toru Takematsu Yuki Sakamoto Mitsuhiro Inoue Yuji Miyamoto Takao Mizumoto Tatsuo Kubota Nobutomo Miyanari Hideo Baba 

作者机构：Department of Gastroenterological SurgeryKumamoto UniversityKumamoto 860-8556Japan Department of SurgeryNational Hospital Organization Kumamoto Medical CenterKumamoto 860-0008Japan Department of Gastroenterological SurgeryGraduate School of Medical SciencesKumamoto UniversityHonjo 860-8556KumamotoJapan 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2022年第14卷第11期

页      面：704-717页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Bridge to surgery Colorectal carcinoma Obstruction Stent Venous invasion 

摘      要：BACKGROUND Experimental studies suggest that self-expanding metal stents(SEMSs)enhance the aggressive behavior of obstructive colorectal *** influence of SEMS placement on pathological alterations remains to be *** To determine whether SEMS placement is associated with molecular or pathological features of colorectal carcinoma *** Using a nonbiased molecular pathological epidemiology database of patients with obstructive colorectal cancers,we examined the association of SEMS placement with molecular or pathological features,including tumor size,histological type,American Joint Committee on Cancer(AJCC)-pTNM stage,and mutation statuses in colorectal cancer tissues compared with the use of transanal tubes.A multivariable logistic regression model was used to adjust for potential *** SEMS placement was significantly associated with venous invasion(P0.01),but not with the other features examined,including tumor size,disease stage,mutation status,and lymphatic *** both the univariable and multivariable models with adjustment for potential factors including tumor location,histological type,and AJCC-pT stage,SEMS placement was significantly associated with severe venous invasion(P0.01).For the outcome category of severe venous invasion,the multivariable odds ratio for SEMS placement relative to transanal tube placement was 19.4(95%confidence interval:5.24–96.2).No significant differences of disease-free survival and overall survival were observed between SEMS and transanal tube *** SEMS placement might be associated with severe venous invasion in colorectal cancer tissue,providing an impetus for further investigations on the pathological alterations by SEMSs in colorectal cancer development.