Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.
Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda.
World J Surg Oncol. 2023 Jul 22;21(1):215. doi: 10.1186/s12957-023-03094-7.
In Western countries, right-sided colon cancers (RSCC) present at an older age and advanced stage. Researchers believe that there is a difference between left-sided colon cancer (LSCC) and RSCC. In Uganda, however, it is unknown whether differences exist in the pathological profile between RSCC and LSCC. The aim of this study was to determine the differences in clinicopathological characteristics between RSCC and LSCC in Ugandan patients.
A cross-sectional study was conducted in which colorectal adenocarcinoma formalin-fixed paraffin-embedded tissue (FFPE) blocks were obtained from 2008 to 2021. Colorectal specimens were obtained from prospectively recruited patients. In the retrospective study arm, FFPE blocks and data were obtained from the archives of pathology laboratory repositories. Parameters studied included age, sex, location of the tumour, grade, stage, lymphovascular (LVI) status, and histopathological subtype between LSCC and RSCC.
Patients with RSCC were not older than those with LSCC (mean age, 56.3 years vs 53.5 years; p = 0.170). There was no difference in the stage between RSCC and LSCC. Poorly differentiated tumours were more commonly found in RSCC than in LSCC (18.7% vs 10.1%; p = 0.038). Moderately and poorly differentiated colonic tumours were more common with RSCC (89.3%) than with LSCC (75.1%) (p = 0.007). Younger patients had more poorly differentiated tumours than older patients (19.6% versus 8.6%; p = 0.002). LVI was more common with RSCC than with LSCC (96.8% vs 85.3%; p = 0.014). Mucinous adenocarcinoma (MAC) was more common with RSCC (15.8%) compared with LSCC (8.5%) (p = 0.056) although statistical significance was borderline.
Clinicopathological features of RSCCs tend to be different from those of LSCCs. RSCCs tend to be associated with MAC, a higher grade and LVI status compared to LSCC. LSCC and RSCC present predominantly with an advanced stage; therefore, national screening programmes for the early detection of CRC are necessary to reduce mortality in our Ugandan population.
在西方国家，右侧结肠癌（RSCC）的发病年龄较大，且处于晚期。研究人员认为，左侧结肠癌（LSCC）和 RSCC 之间存在差异。然而，在乌干达，尚不清楚 RSCC 和 LSCC 之间在病理特征方面是否存在差异。本研究旨在确定乌干达患者中 RSCC 和 LSCC 的临床病理特征差异。
本研究为一项横断面研究，2008 年至 2021 年期间收集了经福尔马林固定石蜡包埋（FFPE）的结直肠腺癌组织标本。前瞻性招募的患者获得结直肠标本。在回顾性研究臂中，从病理实验室存储库的 FFPE 块和数据中获得标本。研究的参数包括 LSCC 和 RSCC 之间的年龄、性别、肿瘤位置、分级、分期、淋巴血管（LVI）状态和组织病理学亚型。
RSCC 患者的年龄不比 LSCC 患者大（平均年龄，56.3 岁比 53.5 岁；p=0.170）。RSCC 和 LSCC 之间的分期没有差异。RSCC 中低分化肿瘤比 LSCC 中更常见（18.7%比 10.1%；p=0.038）。RSCC 中更常见的是中低分化结肠肿瘤（89.3%）而 LSCC 中更常见的是中高分化肿瘤（75.1%）（p=0.007）。年轻患者比老年患者有更多的低分化肿瘤（19.6%比 8.6%；p=0.002）。RSCC 中的 LVI 比 LSCC 更常见（96.8%比 85.3%；p=0.014）。RSCC 中黏液性腺癌（MAC）比 LSCC 更常见（15.8%比 8.5%）（p=0.056），尽管统计学意义是临界的。
RSCC 的临床病理特征与 LSCC 不同。与 LSCC 相比，RSCC 更常与 MAC、高分级和 LVI 状态相关。LSCC 和 RSCC 主要表现为晚期；因此，需要在乌干达开展全国性的 CRC 早期检测筛查计划，以降低我们人群的死亡率。
