title: Drug allergy and the risk of lymph node metastasis in rectal cancer.
abstract: BACKGROUND
  Previous epidemiologic studies have reported that a history of allergy is associated with reduced risk of colorectal cancer and other malignancies. However, no information is available for the association between allergy and the risk of lymph node metastasis. Our study was designed to determine this association in rectal cancer.
  
  
  METHODS
  Patients who were treated at our hospital in the period from January 2003 to June 2011, and with a pathologically hospital discharge diagnosis of rectal adencarcinoma, were included. The clinical, laboratory, and pathologic parameters were analyzed. A multivariate logistic regression model was used to determine the association. Moreover, for type of allergic drug, sub-group analysis was performed.
  
  
  RESULTS
  469 patients were included, including 231 with pathological lymph node metastasis (pLNM) (49.3%) and 238 without pLNM. Univariate analysis showed, compared with patients without pLNM, patients with pLNM had a younger age (60.6 ± 12.8 yr vs. 63.6 ± 12.2 yr, P = 0.012), a lower percentage of drug allergy (8.7% vs. 16.0%, P = 0.016), an increased CEA (median/interquartile-range 5.40/2.40-13.95 vs. 3.50/2.08-8.67, P = 0.009), and a lower serum sodium (141 ± 3.1 mmol/L vs. 142 ± 2.9 mmol/L, P = 0.028). Multivariate analysis showed that drug allergy was associated with a reduced risk of pLNM (OR = 0.553; 95% CI, 0.308-0.994; P = 0.048). In addition, our results showed that: (1) for tumor classification, patients with drug allergy had a higher percentage of group patients with pT1/pT2; and (2) for type of allergic drug, this inverse association was found for penicillins, not for other allergic drugs.
  
  
  CONCLUSIONS
  Drug allergy is associated with a reduced risk of pLNM in rectal cancer.
authors.affiliation: Department of Gastroenterology, China-Japan Friendship Hospital, Ministry of Health, Beijing, P. R. China.
authors.forename: Chun
authors.initials: C
authors.lastname: Gao
authors.affiliation: Department of Gastroenterology, China-Japan Friendship Hospital, Ministry of Health, Beijing, P. R. China.
authors.forename: Jing-Tao
authors.initials: JT
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, China-Japan Friendship Hospital, Ministry of Health, Beijing, P. R. China.
authors.forename: Long
authors.initials: L
authors.lastname: Fang
authors.affiliation: Department of Gastroenterology, China-Japan Friendship Hospital, Ministry of Health, Beijing, P. R. China.
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Xu
authors.affiliation: Department of Gastroenterology, China-Japan Friendship Hospital, Ministry of Health, Beijing, P. R. China.
authors.forename: Hong-Chuan
authors.initials: HC
authors.lastname: Zhao
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality / Q000473:pathology; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D004342:Drug Hypersensitivity / Q000097:blood / Q000209:etiology / Q000276:immunology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008198:Lymph Nodes / Q000276:immunology* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D055553:Prescription Drugs / Q000627:therapeutic use; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality / Q000473:pathology; D012964:Sodium / Q000097:blood; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D002272:Carcinoembryonic Antigen; D010406:Penicillins; D055553:Prescription Drugs; D012964:Sodium