Analysis of colorectal cancer morphology in relation to sex, age, location, and family history
Analysis of colorectal cancer morphology in relation to sex, age, location, and family history
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DOI：
10.1007/s00535-011-0520-9
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发表时间：
2012-06-01
影响因子：
6.3
通讯作者：
Papadogiannakis, Nikos
中科院分区：
文献类型：
--
作者：
Ghazi, Sam;Lindforss, Ulrik;Papadogiannakis, Nikos
对结直肠癌(CRC)的研究表明，男性和女性、青年和老年患者、右侧和左侧肿瘤以及散发性和家族性肿瘤的致癌机制不同。这些差异可能反映在形态学上。组织学回顾了2004-2006年瑞典1613例手术患者的癌组织。形态学检查与性别、年龄、位置和家族史有关。右半结肠肿瘤较大，分期较高，分化较差，产生粘蛋白较多，较常有瘤周淋巴细胞浸润性和高水平的肿瘤浸润性淋巴细胞(TIL)，较左半结肠和直肠肿瘤较少有浸润性边缘(P<；0.0001)。年轻患者(60岁)较少有多发性肿瘤，但更常有神经周围侵犯、肿瘤边缘浸润性和高分期肿瘤。TIL、髓质肿瘤和浸润性肿瘤边缘三个特征与性别有关。只有血管侵犯与熟悉程度有关，部位是对肿瘤形态影响最大的因素。研究结果支持右半结肠和左半结肠可能存在不同致癌机制的观点。年龄是多发性肿瘤存在的最重要的决定因素，也是疾病侵袭性的关键因素。
Studies of colorectal cancer (CRC) have suggested different mechanisms of carcinogenesis in men and women, young and old patients, right- and left sided tumors, and sporadic and familial tumors. These differences might be reflected in morphology.CRCs from 1613 patients operated on in 2004-2006 in Sweden were histologically reviewed. Morphology was examined in relation to sex, age groups, location, and family history.Tumors in the right colon were larger, of higher stage, more often poorly differentiated, more mucin-producing, more often had a peritumoral lymphocytic infiltrate and a high level of tumor-infiltrating lymphocytes (TILs), and more seldom had an infiltrating margin than tumors in the left colon and rectum (p < 0.0001 for most features). Young patients (< 60 years) more seldom had multiple tumors but more often had perineural invasion, an infiltrative tumor margin, and high-stage tumors. Three features, TILs, medullary tumors, and invasive tumor margin, were related to sex. Only vascular invasion was related to familiality.Location is the factor that has the most influence on tumor morphology. The results support the idea that different carcinogenic mechanisms may be involved in the right and left colon. Age is the most important determinant for the presence of multiple tumors and is a crucial factor for the aggressiveness of the disease.