Kim Kwangmin, Castro Ernes John T, Shim Hongjin, Advincula John Vincent G, Kim Young-Wan
Big Data Research Group, Yonsei University Wonju College of Medicine, Wonju, Korea.
Division of Acute Care Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.
Ann Coloproctol. 2018 Dec;34(6):280-285. doi: 10.3393/ac.2018.12.17. Epub 2018 Dec 31.
For many years, developmental and physiological differences have been known to exist between anatomic segments of the colorectum. Because of different outcomes, prognoses, and clinical responses to chemotherapy, the distinction between right colon cancer (RCC) and left colon cancer (LCC) has gained attention. Furthermore, variations in the molecular features and gut microbiota between right and LCCs have recently been a hot research topic. CpG island methylator phenotype-high, microsatellite instability-high colorectal cancers are more likely to occur on the right side whereas tumors with chromosomal instability have been detected in approximately 75% of LCC patients and 30% of RCC patients. The mutation rates of oncogenes and tumor suppressor genes also differ between RCC and LCC patients. Biofilm is more abundant in RCC patients than LLC patients, as are Prevotella, Selenomonas, and Peptostreptococcus. Conversely, Fusobacterium, Escherichia/Shigella, and Leptotrichia are more abundant in LCC patients compared to RCC patients. Distinctive characteristics are apparent in terms of molecular features and gut microbiota between right and LCC. However, how or to what extent these differences influence diverging oncologic outcomes remains unclear. Further clinical and translational studies are needed to elucidate the causative relationship between primary tumor location and prognosis.
多年来，人们已经知道结直肠的解剖节段之间存在发育和生理差异。由于化疗的结果、预后和临床反应不同，右半结肠癌（RCC）和左半结肠癌（LCC）之间的区别受到了关注。此外，右半结肠癌和左半结肠癌之间分子特征和肠道微生物群的差异最近成为一个热门研究话题。CpG岛甲基化表型高、微卫星不稳定性高的结直肠癌更有可能发生在右侧，而在大约75%的左半结肠癌患者和30%的右半结肠癌患者中检测到具有染色体不稳定性的肿瘤。右半结肠癌和左半结肠癌患者中癌基因和肿瘤抑制基因的突变率也有所不同。与左半结肠癌患者相比，右半结肠癌患者中的生物膜、普雷沃氏菌、月形单胞菌和消化链球菌更为丰富。相反，与右半结肠癌患者相比，左半结肠癌患者中的具核梭杆菌、大肠埃希菌/志贺菌和纤毛菌更为丰富。右半结肠癌和左半结肠癌在分子特征和肠道微生物群方面存在明显的差异。然而，这些差异如何或在多大程度上影响不同的肿瘤学结果仍不清楚。需要进一步的临床和转化研究来阐明原发性肿瘤位置与预后之间的因果关系。
