背景:在西方国家,右侧结肠癌(RSCC)存在于老年和晚期。研究人员认为,左半结肠癌(LSCC)和RSCC之间存在差异。在乌干达,然而,目前尚不清楚RSCC和LSCC之间的病理特征是否存在差异.这项研究的目的是确定乌干达患者RSCC和LSCC之间临床病理特征的差异。
方法:进行了一项横断面研究,其中从2008年至2021年获得了结直肠腺癌福尔马林固定的石蜡包埋组织(FFPE)块。从前瞻性招募的患者获得结肠直肠标本。在回顾性研究中,FFPE块和数据从病理学实验室存储库的档案中获得。研究的参数包括年龄,性别,肿瘤的位置,grade,舞台,淋巴管(LVI)状态,以及LSCC和RSCC之间的组织病理学亚型。
结果:患有RSCC的患者不比患有LSCC的患者年龄大(平均年龄,56.3年vs53.5年;p=0.170)。RSCC和LSCC的分期没有差异。低分化肿瘤在RSCC中比在LSCC中更常见(18.7%对10.1%;p=0.038)。中度和低分化的结肠肿瘤在RSCC(89.3%)中比在LSCC(75.1%)中更常见(p=0.007)。年轻患者的低分化肿瘤比老年患者多(19.6%对8.6%;p=0.002)。LVI在RSCC中比在LSCC中更常见(96.8%vs85.3%;p=0.014)。与LSCC(8.5%)相比,粘液腺癌(MAC)在RSCC中更为常见(15.8%)(p=0.056),尽管统计学上具有交界意义。
结论:RSCCs的临床病理特征倾向于与LSCCs不同。RSCC倾向于与MAC相关联,与LSCC相比,具有更高的年级和LVI状态。LSCC和RSCC主要存在于高级阶段;因此,早期发现CRC的国家筛查方案对于降低乌干达人口的死亡率是必要的。
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.