title: Systemic inflammatory response associated with distant metastasis of T1 or T2 colorectal cancer.
abstract: BACKGROUND
  There are currently no studies examining the relationship between systemic inflammatory response and distant metastasis in colorectal cancer patients.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the association of a systemic inflammatory response on distant metastasis by examining clinicopathological factors in patients with colorectal cancer infiltrating the submucosal layer (T1) or the proper muscular layer (T2).
  
  
  METHODS
  Univariate analysis was performed to evaluate the influence of a systemic inflammatory response on distant metastasis in patients with T1 or T2 colorectal cancer using collected clinicopathological data.
  
  
  RESULTS
  Between 1993 and 2008, 156 patients with pathologically diagnosed T1 or T2 colorectal cancer were enrolled. Univariate analysis using clinicopathological factors and Glasgow Prognostic Score (GPS) (0, 1/2) demonstrated that, as well as lymph node metastasis, administration of oral anti-cancer drug and CEA, CRP (odds ratio, 36.25; 95% CI 4.026-326.4; P = 0.001) and GPS (odds ratio, 24.50; 95% CI 1.715-349.9; P =0.018) were associated with distant metastasis.
  
  
  CONCLUSIONS
  CRP and GPS are associated with distant metastasis of T1 or T2 colorectal cancer. Because of the small number of patients with stage IV disease (n =4), a multi-center retrospective study is needed to confirm these findings.
authors.affiliation: Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan. mm-ishizuka@umin.ac.jp
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ishizuka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nagata
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Takagi
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kubota
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000556:secondary*; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000453:epidemiology*
chemical_list: D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D002097:C-Reactive Protein