右半结肠癌和左半结肠癌在患者特征、癌症形态及组织学方面的差异。

Differences between right- and left-sided colon cancer in patient characteristics, cancer morphology and histology.

作者信息

Nawa Toru, Kato Jun, Kawamoto Hirofumi, Okada Hiroyuki, Yamamoto Hiroshi, Kohno Hiroyuki, Endo Hisayuki, Shiratori Yasushi

机构信息

Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

出版信息

J Gastroenterol Hepatol. 2008 Mar;23(3):418-23. doi: 10.1111/j.1440-1746.2007.04923.x. Epub 2007 May 27.

DOI:10.1111/j.1440-1746.2007.04923.x

PMID:17532785

Abstract

BACKGROUND AND AIM

Recently, the clinical and biological differences between right- and left-sided colon cancers have been widely debated. However, close analyses of these clinical differences, based on large-scale studies, have been scarcely reported.

METHODS

A total of 3552 consecutive Japanese colorectal cancer cases were examined and the clinical differences between right- and left-sided colon cancer cases were investigated.

RESULTS

The proportion of right-sided colon cancer was relatively high in patients aged less than 40 years (33%) and more than 80 years (43%). The proportion of right-sided colon cancer in patients aged 40-59 years was relatively low (male 22% and female 29%). In male patients the proportion increased in the 70-79 years age group (30%), while in female patients the proportion increased in the 60-69 years age group (39%). Right-sided colon cancer was more likely to be detected at an advanced stage (T1 stage; left 22%, right 15%) (P < 0.01) with severe symptoms. Polypoid-type early cancer was dominant in the left colon (left 59%; right 40%) (P < 0.01), while the proportion of flat-type early cancer in the right colon was significantly higher than that in the left colon (left 25%; right 44%) (P < 0.01).

CONCLUSIONS

Specific age distribution of right-sided colon cancer was observed and the difference between male and female patients was highlighted. Other clinical features also differed between right- and left-sided colon cancer, suggesting that different mechanisms may be at work during right and left colon carcinogenesis.

摘要

背景与目的

近年来，右半结肠癌和左半结肠癌之间的临床及生物学差异一直备受广泛争议。然而，基于大规模研究对这些临床差异进行的深入分析却鲜有报道。

方法

对连续的3552例日本结直肠癌病例进行检查，研究右半结肠癌和左半结肠癌病例之间的临床差异。

结果

年龄小于40岁（33%）和大于80岁（43%）的患者中，右半结肠癌的比例相对较高。40 - 59岁患者中右半结肠癌的比例相对较低（男性为22%，女性为29%）。男性患者中，70 - 79岁年龄组的比例有所增加（30%），而女性患者中，60 - 69岁年龄组的比例有所增加（39%）。右半结肠癌更易在晚期（T1期；左半结肠癌为22%，右半结肠癌为15%）被检测到，且症状严重（P < 0.01）。息肉样早期癌在左半结肠占主导（左半结肠为59%；右半结肠为40%）（P < 0.01），而右半结肠平坦型早期癌的比例显著高于左半结肠（左半结肠为25%；右半结肠为44%）（P < 0.01）。