国际肿瘤学杂志 ›› 2015, Vol. 42 ›› Issue (4): 305-308.doi: 10.3760/cma.j.issn.1673-422X.2015.04.018

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左右半大肠癌的差异

  

  1. 310009杭州,浙江大学医学院第二附属医院肿瘤内科(杨姣、钟献、袁瑛),肿瘤防治研究所(傅健飞)
  • 出版日期:2015-04-08 发布日期:2015-04-22
  • 通讯作者: 袁瑛,Email: yuanying1999@zju.edu.cn

Differences between right-sided and left-sided intestinal cancers

  1. Department of Medical Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
  • Online:2015-04-08 Published:2015-04-22
  • Contact: Yuan Ying, Email: yuanying1999@zju.edu.cn

摘要: 结直肠癌的发病率在发达国家呈下降趋势,与结肠镜筛查、人口老龄化、饮食结构调整、癌症和糖尿病发病率升高等有关,性别、种族、教育等因素也起一定作用。右半大肠癌中,低分化和晚期疾病比例高,腺癌中黏液成分多,易出现并发症和肠内第二原发肿瘤;而左半大肠癌多呈高分化,诊断时偏早期。分子机制上,右半大肠癌与错配修复基因密切相关,而左半大肠癌与p53突变联系紧密。左、右半大肠癌存在众多表观和遗传学差异,可能属于两种不同的疾病,在临床工作和试验中应区别对待。

关键词: 结直肠肿瘤, 疾病特征, 肿瘤部位

Abstract: Decreasing trend has occurred in incidence of colorectal cancer in developed countries. A shift from left to right in location of colorectal cancer has been recognized, which may be associated with colonoscopy screening, aging population, diet structure modification, increased incidence of cancer and diabetes. Factors including sex, race and education may also play a role to some extent. Rightsided intestinal cancers have higher proportion of poor differentiation, terminal stage and mucinous component. Complications and second primary intestinal cancer are more common in rightsided intestinal cancers. Leftsided intestinal cancers tend to be well differentiated and at relatively early stage at diagnosis. With respect to molecular mechanism, rightsided cancers are associated with mismatch repair system, while leftsided cancers are related to p53 mutation. Based on the differences in clinicopathology and genetics, it′s implied that leftsided and rightsided intestinal cancers may belong to two different kind of disease. It′s suggested that attentions should be paid differently according to their respective characteristics in clinical practice and trials.

Key words: Colorectal neoplasms, Disease attributes, Neoplasm site