| Objectives:Understand the composition and the changing of colorectal cancer in different anatomic subsite, compare the clinical, pathological and biochemical features, to correctly understand and grasp the differences in right-sided colon cancer, left-sided colon cancer and rectal cancer. Lay a foundation to further study about the pathogenesis and its diagnosis and treatment of colorectal cancer.Methods:Retrospectively collected the clinicopathological characteristics data of 1024 colorectal cancer patients with complete data in Zhongda hospital of Southeast university from January 2006 to December 2015, analyzing and comparing clinicopathological characteristics of colorectal cancer in different anatomic subsite. Discussing and comparing the results with similar materials at home and abroad.Results:1. The right-sided colon cancer, the left-sided colon cancer and rectal cancer have the similar component ratio. Left-sided colon cancer in recent 4 years has annually rising.2. The component ratio of elderly patients is higher than the middle-aged, and the component ratio of middle-aged patients is higher than the young. The component of age is significantly different in three groups (P= 0.007< 0.05).Colorectal cancer group of young and middle-aged patients constitute a ratio higher than that of colon cancer, while the colon cancer component ratio is higher than that of rectal cancer in elderly patients.3. Male with colorectal cancer is more than female, and the component of gender has a significant difference in three groups (P= 0.001< 0.05). The female right-sided colon cancer (15.8%) is higher than the female left-side colon cancer (9.7%) (P=0.000<0.05). While the male right-sided colon cancer (17.2%) is lower than the male rectal cancer (23.3%) (P=0.017<0.05).4. The histological type (P=0.000<0.05), the differentiation degree (P=0.002<0.05) and stage (P= 0.000<0.05) are significantly different in three groups. The right colon mucous adenocarcinoma is higher than the left colon and rectal. The right colon adenocarcinoma is obvious lower than the rectal. The right colon poorly differentiated carcinoma is obvious higher than the left colon and rectal. The stage I rectal cancer is higher than the that in right-sided and left-sided colon.5. The CEA positive rate is 30.3% and the CA19-9 positive rate is 12.3%. CEA positive rate (P=0.909) and CA19-9 positive rate (P=0.400) have no statistically significant difference in three groups. But the poorly differentiated colorectal cancer has the higher CEA positive rate and CA19-9 high positive rate, colorectal mucous adenocarcinoma or other cancr have the high positive rate of CA19-9.The expression of p53, hMLH1?hMSH2and COX2 in colorectal cancer were high, but only the expression of hMLH1 in three groups is significant different. The expression of hMLH1 in right-sided colon cancer is lower than left-sided colon cancer and rectal.Conclusions:1. The component ratio of right-sided colon cancer has no obvious rise in recently 10 years, and the left-sided colon cancer has an annually rising in recently 4 years. So we should pay an attention to the left-sided colon cancer.2. Elderly patients are susceptibility to colon cancer, especially right-sided colon cancer. While the young and middle-aged patients with rectal cancer more. Male with colorectal cancer is more than female, but female is more susceptible to the right-sided colon cancer. The proportions of the mucous adenocarcinoma and poorly differentiated tumors in right-sided colon cancer are significantly higher than left-sided colon cancer and rectal cancer, which means the right-sided colon cancer has poor prognosis. The CEA positive rate and CA19-9 positive rate is higher, the worse prognosis of colorectal cancer.3. The hMLH1 expression rate is low in the right-sided colon cancer, which show right-sided colon cancer is more of MSI positive tumors. |
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