″Left, right″: Research progress in pathogenesis of colon cancer based on primary site and clinical treatment decision

doi:10.3877/cma.j.issn.2095-3224.2019.06.002

Abstract

Abstract:

Colon cancer is one of the most common malignant tumor of digestive system, about 1/5 of colon cancer patients had distant organ metastasis at the first diagnosis, tumor occurrence in the left colon or right colon is considered to be an important factor in judging the prognosis of patients. At present, through systematic research on the clinical manifestations and pathogenesis of colon cancer, the results showed that there was a significant difference between left-sided colon cancer (LCC) and right-sided colon cancer (RCC), which will directly affect the choice of treatment plan for patients. Therefore, in this paper, we mainly study intestinal flora, the mechanism of recurrence and metastasis and prognosis to explore and better understand the differences between left and right colon cancer, providing further theoretical basis for individualized and precise treatment of colon cancer patients.

Key words: Colonic neoplasms, Prognosis, Primary site, Difference, Clinical decision-making

Zhongmao Fu, Chen Huang. ″Left, right″: Research progress in pathogenesis of colon cancer based on primary site and clinical treatment decision[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2019, 08(06): 546-552.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhjzcjbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3224.2019.06.002

https://zhjzcjbdzzz.cma-cmc.com.cn/EN/Y2019/V08/I06/546

Figures/Tables 4

References 32

[1]	Siegel R, Miller K, Jemal A. Cancer statistics, 2019 [J]. CA Cancer J Clin, 2019, 69: 7-34.
[2]	曹毛毛，陈万青. 中国恶性肿瘤流行情况及防控现状[J]. 中国肿瘤临床, 2019, 46(3): 145-148.
[3]	Cannon E, Buechler S. Colon Cancer Tumor Location Defined by Gene Expression May Disagree With Anatomic Tumor Location[J]. Clin Colorectal Cancer, 2019, 6, 18(2): 149-158.
[4]	黄陈，戎泽印. 结直肠癌诊治新进展[J]. 蚌埠医学院学报, 2018, 43(10): 1293-1297.
[5]	Son HJ, Sohn SH, Lee SM, et al. Effect of estradiol in an azoxymethane/dextran sulfate sodium-treated mouse model of colorectal cancer: implication for sex difference in colorectal cancer development [J]. Cancer Res Treat, 2019, 51(2): 632-648.
[6]	Menigatti M, Truninger K, Gebbers JO, et al. Normal colorectal mucosa exhibits sex-and segment-specific susceptibility to DNA methylation at the hMLH1 and MGMT promoters [J]. Oncogene, 2009, 28: 899-909.
[7]	于明珠，张修石，王洪伟, 等. MRI联合多层螺旋CT增强扫描对结肠癌术前T分期的应用价值[J]. 现代肿瘤医学, 2016, 24(18): 2967-2971.
[8]	方立挺，施剑斐，潘细根. MRI与多层螺旋CT诊断结肠癌致肠梗阻临床价值分析[J]. 医学影像学杂志, 2018, 28(1): 157-159.
[9]	Yu L, Eresen A, Lu Y, et al. Radiomics signature for the preoperative assessment of stage in advanced colon cancer [J]. Am J Cancer Res, 2019, 9(7): 1429-1438.
[10]	吴涵，余志龙，黄陈. 人工智能技术在结直肠癌中的应用与展望[J/CD]. 中华结直肠疾病电子杂志, 2019, 8(2): 115-119.
[11]	Hugen N, Nagtegaal ID. Distinct metastatic patterns in colorectal cancer patients based on primary tumour location [J]. Eur J Cancer, 2017, 4(75): 3-4.
[12]	Tie J, Lipton L, Desai J, et al. KRAS mutation is associated with lung metastasis in patients with curatively resected colorectal cancer [J]. Clin Cancer Res, 2011, 17: 1122-130.
[13]	Urosevic J, Garcia-Albéniz X, PlaNETs E, et al. Colon cancer cells colonize the lung from established liver metastases through p38 MAPK signalling and PTHLH [J]. Nat Cell Biol, 2014, 16: 685-694.
[14]	Yaeger R, Cercek A, Chou JF, et al. BRAF mutation predicts for poor outcomes after metastasectomy in patients with metastatic colorectal cancer [J]. Cancer, 2014, 8, 120(15): 2316-2324.
[15]	Yaeger R, Cowell E, Chou JF, et al. RAS mutations affect pattern of metastatic spread and increase propensity for brain metastasis in colorectal cancer [J]. Cancer, 2015, 121: 1195-1203.
[16]	Rungroj N, Sudtachat N, NETstuwakul C, et al. Association between human prothrombin variant (T165M) and kidney stone disease [J]. PLoS One, 2012, 7(9): e45533.
[17]	Yaeger R, Chatila WK, Lipsyc MD, et al. Clinical sequencing defines the genomic landscape of metastatic colorectal cancer [J]. Cancer Cell, 2018, 33(1): 125-136.e3.
[18]	Carethers JM, Jung BH. GeNETsics and geNETsic biomarkers in sporadic colorectal cancer [J]. Gastroenterology, 2015, 149: 1177-1190. e3.
[19]	Shen H, Yang J, Huang Q, et al. Different treatment strategies and molecular features between right-sided and left-sided colon cancers [J]. World J Gastroenterol, 2015, 21(21): 6470-6478.
[20]	East JE, Atkin WS, Bateman AC, et al. British Society of Gastroenterology position statement on serrated polyps in the colon and rectum [J]. Gut, 2017, 66: 1181-1196.
[21]	Zlobec I, Bihl M, Foerster A, et al. Comprehensive analysis of CpG island methylator phenotype (CIMP)-high, -low, and-negative colorectal cancers based on protein marker expression and molecular features [J]. J Pathol, 2011, 225(3): 336-343.
[22]	周薇，毕嘉欣，冶亚平, 等. INHBA基因表达上调与左、右半结肠癌临床病理特征及预后的相关性[J]. 临床与实验病理学杂志, 2018, 34(9): 953-956.
[23]	Heinemann V, von Weikersthal LF, Decker T, et al. FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer (FIRE-3): a randomised, open-label, phase 3 trial [J]. Lancet Oncol, 2014, 15: 1065-1075.
[24]	von Einem JC, Heinemann V, von Weikersthal LF, et al. Left-sided primary tumors are associated with favorable prognosis in patients with KRAS cod on 1213 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.
[25]	Ulivi P, Scarpi E, Chiadini E, et al. Right-vs. left-sided metastatic colorectal cancer: differences in tumor biology and bevacizumab efficacy [J]. Int J Mol Sci, 2017, 18(6): 1240-1251.
[26]	Diagnosis And Treatment Guidelines For Colorectal Cancer Working Group Chinese Society Of Clinical Oncology CSCO. Chinese Society of Clinical Oncology (CSCO) diagnosis and treatment guidelines for colorectal cancer 2018 [J]. Chinese Journal of Cancer Research, 2019, 31(1): 117-134.
[27]	王畅. 微卫星状态对结肠癌术后辅助化疗决策的影响[J/CD]. 中华结直肠疾病电子杂志, 2018, 7(3): 207-213.
[28]	杨琦，孔祥兴，丁克峰. 左、右半结肠癌的预后及分子生物学特征差异[J]. 世界华人消化杂志, 2016, 24(24): 3556-3563.
[29]	Cha Y, Kim KJ, Han SW, et al. Adverse prognostic impact of the CpG island methylator phenotype in metastatic colorectal cancer [J]. Br J Cancer, 2016, 115(2): 164-171.
[30]	Guinney J, Dienstmann R, Wang X, et al. The consensus molecular subtypes of colorectal cancer [J]. Nat Med, 2015, 21: 1350-1356.
[31]	Bauer KM, Hummon AB, Buechler S. Right-side and left-side colon cancer follow different pathways to relapse [J]. Mol Carcinog, 2012, 51(5): 411-421.
[32]	黄陈，章靖. 左半结肠癌梗阻外科治疗策略演变[J/CD]. 中华结直肠疾病电子杂志, 2017, 6(2):94-97.

特征	右半结肠	左半结肠
年龄	年龄偏大	年龄偏小
性别	女性多见	男性多见
肿瘤大小	相对较大	相对较小
腹部包块的有无	不易触及腹部包块	易触及腹部包块
病理类型	黏液腺样癌、未分化癌、印戒细胞癌	腺癌，分化程度高
临床表现	贫血、乏力、体重下降等	肠梗阻，排便习惯改变，便血腹痛
转移方式	腹膜及远处淋巴结	肝、肺转移常见

特征	右半结肠	左半结肠
年龄	年龄偏大	年龄偏小
性别	女性多见	男性多见
肿瘤大小	相对较大	相对较小
腹部包块的有无	不易触及腹部包块	易触及腹部包块
病理类型	黏液腺样癌、未分化癌、印戒细胞癌	腺癌，分化程度高
临床表现	贫血、乏力、体重下降等	肠梗阻，排便习惯改变，便血腹痛
转移方式	腹膜及远处淋巴结	肝、肺转移常见

文献	肿瘤位置	一线化疗方案＋bev（例）vs.一线化疗方案＋cet/pani（例）	OS（月）	P值	PFS（月）	P值
FIRE-3	LCC	149 vs. 157	28.0 vs. 38.3	0.002	10.7 vs. 10.7	0.38
FIRE-3	RCC	50 vs. 38	23.0 vs. 18.3	0.28	9.0 vs. 7.6	0.11
CALGB 80405	LCC	152 vs. 173	32.6 vs. 39.3	0.04	11.2 vs. 12.7	0.15
CALGB 80405	RCC	78 vs. 71	29.2 vs. 13.7	0.10	10.2 vs. 7.5	0.006
PEAK	LCC	53 vs. 54	43.4 vs. 32.0	未报道	14.6 vs. 11.5	未报道
PEAK	RCC	22 vs. 14	17.5 vs. 21.0	未报道	8.7 vs. 12.6	未报道

文献	肿瘤位置	一线化疗方案＋bev（例）vs.一线化疗方案＋cet/pani（例）	OS（月）	P值	PFS（月）	P值
FIRE-3	LCC	149 vs. 157	28.0 vs. 38.3	0.002	10.7 vs. 10.7	0.38
FIRE-3	RCC	50 vs. 38	23.0 vs. 18.3	0.28	9.0 vs. 7.6	0.11
CALGB 80405	LCC	152 vs. 173	32.6 vs. 39.3	0.04	11.2 vs. 12.7	0.15
CALGB 80405	RCC	78 vs. 71	29.2 vs. 13.7	0.10	10.2 vs. 7.5	0.006
PEAK	LCC	53 vs. 54	43.4 vs. 32.0	未报道	14.6 vs. 11.5	未报道
PEAK	RCC	22 vs. 14	17.5 vs. 21.0	未报道	8.7 vs. 12.6	未报道

文献	治疗方案	LCC（例） vs. RCC（数）	OS（月）	P值	PFS（月）	P值
CRYSTAL	FOLFIRI＋cet	142 vs. 33	28.7 vs. 18.5	0.003	12.0 vs. 8.1	0.02
FIRE-3	FOLFIRI＋cet	157 vs. 38	38.3 vs. 18.3	<0.001	10.7 vs. 7.6	<0.001
CALGB 80405	FOLFIRI/FOLFOX＋cet	173 vs. 71	39.3 vs. 13.6	<0.001	12.7 vs. 7.5	0.002
PRIME	FOLFOX＋pani	169 vs. 39	30.3 vs. 11.1	0.04	12.9 vs. 7.5	0.40
PEAK	FOLFOX＋pani	53 vs. 22	43.4 vs. 17.5	0.007	14.6 vs. 8.7	0.16
20050181	FOLFOX＋pani	150 vs. 31	20.1 vs. 10.3	0.002	8.0 vs. 4.8	0.12

Please choose a citation manager

Content to export