切换至 "中华医学电子期刊资源库"

中华结直肠疾病电子杂志 ›› 2016, Vol. 05 ›› Issue (05) : 380 -385. doi: 10.3877/cma.j.issn.2095-3224.2016.05.003

所属专题: 文献

专家论坛

左、右半结肠癌"两种疾病论"的研究进展
胡俊杰1, 熊治国1,()   
  1. 1. 430071 武汉,湖北省肿瘤医院胃肠外科;湖北省结直肠癌临床医学研究中心
  • 收稿日期:2016-05-29 出版日期:2016-10-25
  • 通信作者: 熊治国

The research advances of a new theory: right-and left-sided colon cancer may be two different kinds of clinical disease

Junjie Hu1, Zhiguo Xiong1,()   

  1. 1. Department of Gastrointestinal Surgery, Hubei Colorectal Cancer Clinical Research Center, Hubei Cancer Hospital, Wuhan 430071, China
  • Received:2016-05-29 Published:2016-10-25
  • Corresponding author: Zhiguo Xiong
  • About author:
    Corresponding author: Xiong Zhiguo, Email:
引用本文:

胡俊杰, 熊治国. 左、右半结肠癌"两种疾病论"的研究进展[J]. 中华结直肠疾病电子杂志, 2016, 05(05): 380-385.

Junjie Hu, Zhiguo Xiong. The research advances of a new theory: right-and left-sided colon cancer may be two different kinds of clinical disease[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2016, 05(05): 380-385.

左、右半结肠胚胎起源不同,肿瘤发生的分子生物学机制不同。统计数据显示右半结肠癌中女性患者及高龄患者比例高;组织学常表现为分化较差的腺癌;MSI(+)、CIMP(+)及BRAF基因突变型更多见。左、右半结肠癌的预后差异与期别相关,Ⅰ期预后相似,Ⅱ期右半结肠癌预后较好,Ⅲ/Ⅳ期右半结肠癌预后较差。结直肠癌不同部位肿瘤分子生物学行为不同,临床治疗上不应被笼统地视为一种疾病,在当前个体化、精准化治疗时代,区分结直肠癌肿瘤部位对评价患者预后及药物疗效尤为重要。

Recently, researchers gradually discovered that the right and left colon cancer has significant difference in molecular mechanism of carcinogenesis, it was possibly due to intestinal epithelium derives from different embryologic origin. Patients with right-sided colon cancer were more likely to be elder, women and poorly differentiated. Frequencies of CIMP+ , MSI+ , BRAF+ were higher in right-sided colon cancer. The prognostic differences between right-and left-colon cancer were associated with tumor stage. For stageⅠthe survival was similar. Right-sided cancer had better survival for stage Ⅱ, but worse survival for stage Ⅲ/Ⅳ. Colorectal cancer origined from different location had different biological behavior, and it should not be regarded as a single entity. In the current era of personalized and precision medicine, tumor locations was quite important in the evaluation of prognosis and drug efficacy.

[1]
Siegel R,Desantis C,Jemal A. Colorectal cancer statistics, 2014[J]. CA: Cancer J Clin, 2014, 64(2): 104-117.
[2]
Bufill JA. Colorectal cancer: evidence for distinct genetic categories based on proximal or distal tumor location[J]. Ann Intern Med, 1990, 113(10): 779-788.
[3]
Boise MK,Johansen JS,Dehlendorff C, et al. Primary tumor location and bevacizumab effectiveness in patients with metastatic colorectal cancer[J]. Annals of Oncology, 2013, 24(10): 2554-2559.
[4]
Ramesh O,Rana D,Habibollah M, et al. Anatomical Distribution of Colorectal Carcinoma in Iran: A Retrospective 15-yr Study to Evaluate Rightward Shift[J].Asian Pacific J Cancer Prev,2012,13(1),279-282.
[5]
Cheng L,Eng C,Nieman LZ, et al. Trends in colo-rectal cancer incidence by anatomic site and disease stage in the United States from 1976 to 2005[J]. Am J Clin Oncol, 2011, 34(6): 573-580.
[6]
Weiss JM,Pfau PR,O'Connor ES, et al. Mortality by stage for right-versus left-sided colon cancer: analysis of surveillance, epidemiology, and end results-Medicare data[J]. J Clin Oncol: official journal of the American Society of Clinical Oncology, 2011, 29(33): 4401-4409.
[7]
Wu, X,Chen, VW,Martin J, et al. Sub-site-specific colorectal cancer incidence rates and stage distributions among Asians an d Pacific Islanders in the United States, 1995 to 1999[J]. Cancer Epidemiol. Biomarkers Prev, 2004, 13(7): 1215-1222.
[8]
Araki K,Furuya Y,Kobayashi M, et al. Comparison of mucosal microvasculature between the proximal and distal human colon[J]. J Electron Microsc (Tokyo), 1996, 45(3): 202-206.
[9]
Skinner SA,O'Brien PE. The microvascular structure of the normal colon in rats and humans[J]. J Surg Res, 1996, 61(2): 482-490.
[10]
Roncucci L,Modica S,Pedroni M,et al. Aberrant crypt foci in patients with colorectal cancer[J]. Br J cancer, 1998, 77(12): 2343-2348.
[11]
Roncucci L,Medline A,Bruce WR. Classification of aberrant crypt foci and microadenomas in human colon[J]. Cancer Epidemiol Biomarkers Prev, 1991, 1(1): 57-60.
[12]
Bara J,Nardelli J,Gadenne C, et al. Differences in the expression of mucus-associated antigens between proximal and distal human colon adenocarcinomas[J]. Br J cancer, 1984, 49(4): 495-501
[13]
Sun Y,O'Riordan MX. Regulation of bacterial pathogenesis by intestinal short-chain Fatty acids[J]. Adv Appl Microbiol, 2013, 85: 93-118.
[14]
Macfarlane GT,Gibson GR,Cummings JH. Comparison of fermentation reactions in different regions of the human colon[J]. J Appl Bacteriol, 1992, 72(1): 57-64.
[15]
Povey AC,Hall CN,Badawi AF, et al. Elevated levels of the pro-carcinogenic adduct, O(6)-methylguanine, in normal DNA from the cancer prone regions of the large bowel[J]. Gut, 2000, 47(3): 362-365.
[16]
Payne CM,Bernstein C,Dvorak K,et al. Hydrophobic bile acids, genomic instability, Darwinian selection, and colon carcinogenesis[J]. Clin Exp Gastroenterol, 2008, 1: 19-47.
[17]
Lax S,Schauer G,Prein K, et al. Expression of the nuclear bile acid receptor/farnesoid X receptor is reduced in human colon carcinoma compared to nonneoplastic mucosa independent from site and may be associated with adverse prognosis[J]. Int J Cancer Journal international du cancer, 2012, 130(10): 2232-2239.
[18]
Worthley DL,Leggett BA. Colorectal cancer: molecular features and clinical opportunities[J]. Clin Biochem Rev, 2010, 31(2): 31-38.
[19]
Reichmann A,Levin B,Martin P. Human large-bowel cancer: correlation of clinical and histopathological features with banded chromosomes[J]. Int J Cancer, 1982, 29(6): 625-629.
[20]
Delattre O,Olschwang S,Law DJ, et al. Multiple genetic alterations in distal and proximal colorectal cancer[J]. Lancet, 1989, 2(8659): 353-356.
[21]
Rothberg PG,Spandorfer JM,Erisman MD, et al. Evidence that c-myc expression defines two genetically distinct forms of colorectal adenocarcinoma[J]. Br J Cancer, 1985, 52(4): 629-632.
[22]
Russo A,Bazan V,Iacopetta B, et al. The TP53 colorectal cancer international collaborative study on the prognostic and predictive significance of p53mutation: influence of tumor site, type of mutation, and adjuvant treatment[J]. J Clin Oncol, 2005, 20, 23(30): 7518-7528.
[23]
Weisenberger DJ,Siegmund KD,Campan M, et al. CpG island methylator phenotype underlies sporadic microsatellite instability and is tightly associated with BRAF mutation in colorectal cancer[J]. Nat Genet, 2006, 38(7): 787-793.
[24]
Nosho K,Irahara N,Shima K, et al. Comprehensive biostatistical analysis of CpG island methylator phenotype in colorectal cancer using a large population-based sample[J]. PloS One, 2008, 3(11): e3698.
[25]
Roth AD,Delorenzi M,Tejpar S, et al. Integrated analysis of molecular and clinical prognostic factors in stage Ⅱ/Ⅲ colon cancer[J]. J Natl Cancer Inst. 2012, 104(21): 1635-1646.
[26]
Barault L,Charon-Barra C,Jooste V, et al. Hypermethylator phenotype in sporadic colon cancer: study on a population-based series of 582 cases[J]. Cancer Res, 2008, 68(20): 8541-8546.
[27]
Bae JM,Kim JH,Cho NY, et al. Prognostic implication of the CpG island methylator phenotype in colorectal cancers depends on tumour location[J]. Br J Cancer, 2013, 109(4): 1004-1012.
[28]
Yokota T,Ura T,Shibata N, et al. BRAF mutation is a powerful prognostic factor in advanced and recurrent colorectal cancer[J]. Br J Cancer, 2011, 104(5): 856-862.
[29]
Hampel H,Frankel WL,Martin E, et al. Feasibility of screening for Lynch syndrome among patients with colorectal cancer[J]. J Clin Oncol, 2008, 26(35): 5783-5788.
[30]
Hinojosa MW,Konyalian VR,Murrell ZA, et al. Outcomes of right and left colectomy at academic centers[J]. Am Surg, 2007, 73(10): 945-948.
[31]
Kwaan MR,Al-Refaie WB,Parsons HM, et al. Are right-sided colectomy out-comes different from left-sided colectomy outcomes?: study of pa-tients with colon cancer in the ACS NSQIP database[J]. JAMA Surg, 2013, 148(6): 504-510.
[32]
Meguid RA,Slidell MB,Wolfgang CL, et al. Is there a difference in survival between right-versus left-sided colon cancers[J]? Ann Surg Oncol, 2008, 15(9): 2388-2394.
[33]
Price TJ,Beeke C,Ullah S, et al. Does the primary site of colorectal cancer impact outcomes for patients with metastatic disease[J]? Cancer, 2015, 121(6): 830-835.
[34]
Ishihara S,Nishikawa T,Tanaka T, et al. Prognostic impact of tumor location in stage IV colon cancer: a propensity score analysis in a multicenter study[J]. Int J Surg, 2014, 12(9): 925-930.
[35]
Modest DP,Jung A,Moosmann N, et al.The influence of KRAS and BRAF mutations on the efficacy of cetuximab-based first-line therapy of metastatic colorectal cancer: an analysis of the AIO KRK-0104-trial[J]. Int J Cancer, 2012, 131(4): 980-986.
[36]
Brule SY,Jonker DJ,Karapetis CS, et al. Location of colon cancer (right-sided [RC] versus left-sided [LC]) as a predictor of benefit from cetuximab (CET): nCIC CTG CO.17. J Clin Oncol, 2013, 31, (suppl, abstr 3528). Epub 2013 ASCO annual Meeting.
[37]
von Einem JC,Heinemann V,von Weikersthal LF, et al. Left-sided primary tumors are associated with favorable prognosis in patients with KRAS codon 12/13 wild-type metastatic colorectal cancer treated with cetuximab plus chemotherapy: an analysis of the AIO KRK-0104 trial[J]. J Cancer Res Clin Oncol, 2014, 140(9): 1607-1614.
[1] 郏亚平, 曾书娥. 含鳞状细胞癌成分的乳腺化生性癌的超声与病理特征分析[J]. 中华医学超声杂志(电子版), 2023, 20(08): 844-848.
[2] 应康, 杨璨莹, 刘凤珍, 陈丽丽, 刘燕娜. 左心室心肌应变对无症状重度主动脉瓣狭窄患者的预后评估价值[J]. 中华医学超声杂志(电子版), 2023, 20(06): 581-587.
[3] 马伟强, 马斌林, 吴中语, 张莹. microRNA在三阴性乳腺癌进展中发挥的作用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 111-114.
[4] 唐旭, 韩冰, 刘威, 陈茹星. 结直肠癌根治术后隐匿性肝转移危险因素分析及预测模型构建[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 16-20.
[5] 张生军, 赵阿静, 李守博, 郝祥宏, 刘敏丽. 高糖通过HGF/c-met通路促进结直肠癌侵袭和迁移的实验研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 21-24.
[6] 杨倩, 李翠芳, 张婉秋. 原发性肝癌自发性破裂出血急诊TACE术后的近远期预后及影响因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 33-36.
[7] 栗艳松, 冯会敏, 刘明超, 刘泽鹏, 姜秋霞. STIP1在三阴性乳腺癌组织中的表达及临床意义研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 52-56.
[8] 潘冰, 吕少诚, 赵昕, 李立新, 郎韧, 贺强. 淋巴结清扫数目对远端胆管癌胰十二指肠切除手术疗效的影响[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 608-612.
[9] 张其坤, 商福超, 李琪, 栗光明, 王孟龙. 联合脾切除对肝癌合并门静脉高压症患者根治性切除术后的生存获益分析[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 613-618.
[10] 倪文凯, 齐翀, 许小丹, 周燮程, 殷庆章, 蔡元坤. 结直肠癌患者术后发生延迟性肠麻痹的影响因素分析[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 484-489.
[11] 范小彧, 孙司正, 鄂一民, 喻春钊. 梗阻性左半结肠癌不同手术治疗方案的选择应用[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 500-504.
[12] 李永胜, 孙家和, 郭书伟, 卢义康, 刘洪洲. 高龄结直肠癌患者根治术后短期并发症及其影响因素[J]. 中华临床医师杂志(电子版), 2023, 17(9): 962-967.
[13] 徐军, 姬园园, 陈君平, 王健. 伴菊形团结构的脑膜瘤合并颅骨侵犯一例并文献复习[J]. 中华临床医师杂志(电子版), 2023, 17(08): 916-919.
[14] 王军, 刘鲲鹏, 姚兰, 张华, 魏越, 索利斌, 陈骏, 苗成利, 罗成华. 腹膜后肿瘤切除术中大量输血患者的麻醉管理特点与分析[J]. 中华临床医师杂志(电子版), 2023, 17(08): 844-849.
[15] 索利斌, 刘鲲鹏, 姚兰, 张华, 魏越, 王军, 陈骏, 苗成利, 罗成华. 原发性腹膜后副神经节瘤切除术麻醉管理的特点和分析[J]. 中华临床医师杂志(电子版), 2023, 17(07): 771-776.
阅读次数
全文


摘要