左右半大肠癌的差异  

Differences between right-sided and left-sided intestinal cancers

作　　者：杨姣[1] 傅健飞[2] 钟献[1] 袁瑛[1] 

机构地区：[1]浙江大学医学院第二附属医院肿瘤内科,杭州310009 [2]浙江大学医学院第二附属医院肿瘤防治研究所,杭州310009

出　　处：《国际肿瘤学杂志》2015年第4期305-308,共4页Journal of International Oncology

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。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 diabe-tes. 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 mecha-nism,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.

关 键 词：结直肠肿瘤 疾病特征 肿瘤部位 

分 类 号：R735.34[医药卫生—肿瘤]