Natsume Soichiro, Yamaguchi Tatsuro, Takao Misato, Iijima Takeru, Wakaume Rika, Takahashi Keiichi, Matsumoto Hiroshi, Nakano Daisuke, Horiguchi Shin-Ichiro, Koizumi Koichi, Miyaki Michiko
Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan.
Jpn J Clin Oncol. 2018 Jul 1;48(7):609-618. doi: 10.1093/jjco/hyy069.
The aim of this study was to clarify clinicopathological features, frequencies of molecular biomarkers, and prognoses in Japanese colorectal cancer patients and compare them with right-sided colon cancer (RCC) and left-sided colorectal cancer (LCRC).
We consecutively selected 575 colorectal cancer patients who underwent surgical resection from 2008 to 2011. RCC was located from the cecum to the transverse colon, and LCRC was located from the splenic flexure to the rectum. Frequencies of KRAS gene mutation, BRAF gene mutation, microsatellite instability (MSI), l18qLOH and CpG island methylator phenotype (CIMP) were statistically analyzed between groups.
Tumors were located in the RCC in 26.3% of patients and in the LCRC in 73.7%. Elderly patients, females and advanced diseases were significantly more frequent in the RCC group than in the LCRC group. However, venous invasion was significantly more frequent in LCRC than in RCC. Between groups, BRAF mutant type, KRAS mutant type, MSI and CIMP+ were significantly more frequent in RCC, whereas 18qLOH was significantly more frequent in LCRC. In overall survival, RCC demonstrated poor prognosis compared with LCRC; however, age, gender, stage, lymphatic invasion, KRAS status and BRAF status rather than tumor location were independent prognostic factors. In addition, the independent prognostic factors in RCC were different from those in LCRC in each stage. However, the consistency between OS and DFS was not observed in this study, excluding lymphatic invasion in LCRC.
Comparing RCC with LCRC, RCC is different from LCRC in clinicopathological features, molecular biomarkers and prognostic factors in Japanese colorectal cancer patients. Since the proportions of molecular biomarkers of CRC in this study are different from Western CRCs, further studies are required to clarify the clinicopathological differences between Japanese CRCs and Western CRCs.
本研究旨在阐明日本结直肠癌患者的临床病理特征、分子生物标志物频率及预后，并将其与右侧结肠癌（RCC）和左侧结直肠癌（LCRC）进行比较。
我们连续选取了2008年至2011年接受手术切除的575例结直肠癌患者。RCC位于盲肠至横结肠，LCRC位于脾曲至直肠。对两组之间KRAS基因突变、BRAF基因突变、微卫星不稳定性（MSI）、18qLOH和CpG岛甲基化表型（CIMP）的频率进行了统计学分析。
26.3%的患者肿瘤位于RCC，73.7%位于LCRC。RCC组老年患者、女性和晚期疾病的发生率显著高于LCRC组。然而，LCRC的静脉侵犯显著高于RCC。两组之间，BRAF突变型、KRAS突变型、MSI和CIMP+在RCC中显著更常见，而18qLOH在LCRC中显著更常见。在总生存方面，与LCRC相比，RCC预后较差；然而，年龄、性别、分期、淋巴侵犯、KRAS状态和BRAF状态而非肿瘤位置是独立的预后因素。此外，RCC和LCRC在各阶段的独立预后因素不同。然而，本研究未观察到总生存（OS）和无病生存（DFS）之间的一致性，LCRC中排除淋巴侵犯的情况除外。
比较RCC和LCRC，日本结直肠癌患者中RCC在临床病理特征、分子生物标志物和预后因素方面与LCRC不同。由于本研究中结直肠癌分子生物标志物的比例与西方结直肠癌不同，需要进一步研究以阐明日本结直肠癌与西方结直肠癌之间的临床病理差异。
