Guneet Sidhu, MD1, Hussam Almasri, MD2, John Bassett, MD, FACG2 1University of North Dakota, Fargo, ND; 2Sanford Health, Fargo, ND
Introduction:
Pyogenic liver abscess (PLA) and colorectal cancer (CRC) have been increasingly recognized for their potential interrelationship. Studies from Southeast Asia have indicated this association, suggesting that CRC may be an underlying cause of cryptogenic PLA. This association is hypothesized to stem from the translocation of intestinal bacteria through compromised mucosal barriers caused by colorectal neoplasms
Methods:
Cross-sectional study from January 2013 to January 2024 within Sanford Health System. A total of 1,083 patients were diagnosed with liver abscesses, out of which 83 patients developed CRC. Data were collected on patient demographics, timing of CRC and PLA diagnoses, and microbiological findings from abscess. Patients with biliary, gallbladder and post-surgical causes leading to liver abscess were excluded
Results: The incidence rate of CRC in patients with PLA was significantly higher compared to the general population (p < 0.001). Timing of CRC diagnosis relative to PLA revealed that 15 patients (18.07%) were diagnosed with CRC within 6 months prior to PLA, 4 patients (4.82%) within 3 years of PLA diagnosis, 16 patients (19.28%) developed PLA after CRC diagnosis, and 8 patients (9.64%) developed PLA within 1 year post-CRC diagnosis. Using Fine-Gray subdistribution hazard regression model, the hazard ratio (HR) for CRC incidence within the first year after PLA diagnosis was 2.95 (95% CI: 1.75-4.97, p < 0.001). For patients diagnosed with PLA within 6 months prior to CRC, the HR was 3.82 (95% CI: 2.18-6.68, p < 0.001). Microbiological analysis revealed that Bacteroides species and Streptococcus species were predominant in liver abscess cultures followed by E. coli. The presence of Bacteroides species was particularly associated with a higher incidence of CRC (HR: 2.20, 95% CI: 1.35-3.60, p = 0.002
Discussion: Our study reveals a significant association between PLA and the incidence of CRC within our healthcare system over a 10-year period. Patients with PLA demonstrated a notably higher risk of developing CRC, particularly within the first 6 months to 3 years following PLA diagnosis, with hazard ratios indicating a nearly threefold increase in risk. The predominant microorganisms identified Bacteroides and Streptococcus species, were significantly associated with CRC incidence, underscoring potential microbial pathways in CRC pathogenesis.These findings emphasize the necessity for early and comprehensive diagnostic evaluations in patients presenting with cryptogenic PLA.
Disclosures:
Guneet Sidhu indicated no relevant financial relationships.
Hussam Almasri indicated no relevant financial relationships.
John Bassett indicated no relevant financial relationships.
Guneet Sidhu, MD1, Hussam Almasri, MD2, John Bassett, MD, FACG2. P3853 - POSTER WITHDRAWN, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
