Right-sided colon cancers (RCC) and left-sided colon cancers (LCC) have different epidemiological, physiological, pathological, genetic, and clinical characteristics, which result in differences in the course, prognos...Right-sided colon cancers (RCC) and left-sided colon cancers (LCC) have different epidemiological, physiological, pathological, genetic, and clinical characteristics, which result in differences in the course, prognosis, and outcome of disease. The objective of our study is to compare right-sided colon cancers and left-sided colon cancers regarding clinicopathological and survival characteristics. This is a retrospective study of 664 patients with colon cancer treated at the medical oncology department of Fez over a period from December 2009 to September 2020. Rectosigmoid, descending colon, and splenic flexure tumors were considered left-sided colon cancers, whereas ascending colon tumors were considered right-sided colon cancers. The Kaplan Meier method was used to estimate median survival. The study included 664 patients (female, 47%) having colon cancer with a median age of 60 years (23 - 83). Of the patients, 78.5% (n = 519) had LCC and 19.36 % (n = 128) had RCC. The rate of patients aged ≥ 65 years and the rate of patients with a family history of colon cancer was higher in the LCC patients. The proportion of poorly differentiated adenocarcinomas represented 3%, of which 63% had cancer of the right colon. There was a significantly higher proportion of higher T stage (T3-4: 62% vs 38%) in right sided tumors as compared to left sided tumors. The rate of metastatic patients was 64.1% in the RCC group and 43% in the LCC group. The median follow-up period was 14 months in the RCC group and 19 months in the LCC group with higher median overall survival in the LCC group (32 vs 21 months). We found histopathological differences between right and left sided colon cancer. Tumors on the right colon were found to be more aggressive, as expressed by poorer differentiation, higher T stage associated with a median overall survival better in left colon cancer.展开更多
目的:基于右半结肠癌(right-sided colon cancer,RSCC)和左半结肠癌(left-sided colon cancer,LSCC)2个亚群,探索白介素8(interleukin 8,IL-8)基因在2组癌组织中的表达及其临床意义.方法:选择接受根治性手术切除的病理Ⅱ和Ⅲ期结肠癌患...目的:基于右半结肠癌(right-sided colon cancer,RSCC)和左半结肠癌(left-sided colon cancer,LSCC)2个亚群,探索白介素8(interleukin 8,IL-8)基因在2组癌组织中的表达及其临床意义.方法:选择接受根治性手术切除的病理Ⅱ和Ⅲ期结肠癌患者80例,以结肠脾曲为界,分成RSCC组40例和LSCC组40例,采集每个患者的癌组织及其自身配对正常结肠黏膜组织共80对.应用实时定量PCR检测(real-time quantitative PCR,q RT-PCR)的方法检测IL-8基因m RNA在2组患者组织中的表达,并分析其表达和临床病理变量的关系及其对各自预后的影响.结果:无论RSCC还是LSCC,IL-8基因m RNA在癌组织中的表达均显著高于自身正常结肠黏膜的表达(P<0.01);然而,IL-8在RSCC中的表达明显高于LSCC,经检验具有显著性.IL-8高表达患者与RSCC(65%vs 35%,P=0.007),较大肿瘤直径(5.2 cm vs 4.1 cm,P=0.014),和肿瘤浸润淋巴细胞(27.5%vs 10%,P=0.045)显著相关;L S C C患者中I L-8高表达者的中位生存时间明显短于低表达者(37.0 mo vs 59.2 mo,P=0.006),而对RSCC患者的单独分析却发现IL-8高表达者的预后好于低表达者(63.8 mo vs 54.5 mo,P=0.151).多因素分析发现,T4结肠壁浸润(RR=6.514,95%CI:1.209-35.102,P=0.029)和脉管癌栓(RR=6.272,95%CI:1.352-29.092,P=0.019)是RSCC的独立预后因子;IL-8高表达(RR=3.279,95%CI:0.973-11.051,P=0.045)、T4结肠壁浸润(RR=4.546,95%CI:1.335-15.481,P=0.015)、淋巴结转移(RR=5.918,95%CI:1.439-24.334,P=0.014)和脉管癌栓(RR=3.663,95%CI:1.089-12.320,P=0.036)是LSCC的独立预后因子.结论:IL-8基因在RSCC的表达明显高于L S C C,且对两者具有不同的预后意义,是L S C C不良的独立预后因子.可见根据肿瘤部位的不同分析基因表达的临床意义是很有必要.RSCC和LSCC是具有复杂分子差异和不同致癌机制的两个潜在的结肠癌异质性群体.展开更多
文摘Right-sided colon cancers (RCC) and left-sided colon cancers (LCC) have different epidemiological, physiological, pathological, genetic, and clinical characteristics, which result in differences in the course, prognosis, and outcome of disease. The objective of our study is to compare right-sided colon cancers and left-sided colon cancers regarding clinicopathological and survival characteristics. This is a retrospective study of 664 patients with colon cancer treated at the medical oncology department of Fez over a period from December 2009 to September 2020. Rectosigmoid, descending colon, and splenic flexure tumors were considered left-sided colon cancers, whereas ascending colon tumors were considered right-sided colon cancers. The Kaplan Meier method was used to estimate median survival. The study included 664 patients (female, 47%) having colon cancer with a median age of 60 years (23 - 83). Of the patients, 78.5% (n = 519) had LCC and 19.36 % (n = 128) had RCC. The rate of patients aged ≥ 65 years and the rate of patients with a family history of colon cancer was higher in the LCC patients. The proportion of poorly differentiated adenocarcinomas represented 3%, of which 63% had cancer of the right colon. There was a significantly higher proportion of higher T stage (T3-4: 62% vs 38%) in right sided tumors as compared to left sided tumors. The rate of metastatic patients was 64.1% in the RCC group and 43% in the LCC group. The median follow-up period was 14 months in the RCC group and 19 months in the LCC group with higher median overall survival in the LCC group (32 vs 21 months). We found histopathological differences between right and left sided colon cancer. Tumors on the right colon were found to be more aggressive, as expressed by poorer differentiation, higher T stage associated with a median overall survival better in left colon cancer.
基金supported by the National Natural Science Foundation of China(30872463)the Natural Science Foundation of Hunan Province,P.R.China(07JJ5016)the Scientific Research Fund from the Department of Public Health of Hunan Province,P.R.China(C2009-010)
文摘目的:基于右半结肠癌(right-sided colon cancer,RSCC)和左半结肠癌(left-sided colon cancer,LSCC)2个亚群,探索白介素8(interleukin 8,IL-8)基因在2组癌组织中的表达及其临床意义.方法:选择接受根治性手术切除的病理Ⅱ和Ⅲ期结肠癌患者80例,以结肠脾曲为界,分成RSCC组40例和LSCC组40例,采集每个患者的癌组织及其自身配对正常结肠黏膜组织共80对.应用实时定量PCR检测(real-time quantitative PCR,q RT-PCR)的方法检测IL-8基因m RNA在2组患者组织中的表达,并分析其表达和临床病理变量的关系及其对各自预后的影响.结果:无论RSCC还是LSCC,IL-8基因m RNA在癌组织中的表达均显著高于自身正常结肠黏膜的表达(P<0.01);然而,IL-8在RSCC中的表达明显高于LSCC,经检验具有显著性.IL-8高表达患者与RSCC(65%vs 35%,P=0.007),较大肿瘤直径(5.2 cm vs 4.1 cm,P=0.014),和肿瘤浸润淋巴细胞(27.5%vs 10%,P=0.045)显著相关;L S C C患者中I L-8高表达者的中位生存时间明显短于低表达者(37.0 mo vs 59.2 mo,P=0.006),而对RSCC患者的单独分析却发现IL-8高表达者的预后好于低表达者(63.8 mo vs 54.5 mo,P=0.151).多因素分析发现,T4结肠壁浸润(RR=6.514,95%CI:1.209-35.102,P=0.029)和脉管癌栓(RR=6.272,95%CI:1.352-29.092,P=0.019)是RSCC的独立预后因子;IL-8高表达(RR=3.279,95%CI:0.973-11.051,P=0.045)、T4结肠壁浸润(RR=4.546,95%CI:1.335-15.481,P=0.015)、淋巴结转移(RR=5.918,95%CI:1.439-24.334,P=0.014)和脉管癌栓(RR=3.663,95%CI:1.089-12.320,P=0.036)是LSCC的独立预后因子.结论:IL-8基因在RSCC的表达明显高于L S C C,且对两者具有不同的预后意义,是L S C C不良的独立预后因子.可见根据肿瘤部位的不同分析基因表达的临床意义是很有必要.RSCC和LSCC是具有复杂分子差异和不同致癌机制的两个潜在的结肠癌异质性群体.
