| Objectives:To compare the differences of RAS,BRAF mutation status,MLH1,PMS2,MSH2 and MSH6 expression and the clinicopathological characteristics such as tumor stage,infiltration range,differentiation degree and tumor size between the left-sided colon cancer and right-sided colon cancer,to further understand the heterogeneity of the left-sided colon cancer and right-sided colon cancer,in order to provide a reference for clinical treatment and prognosis.Methods:The sample was taken from January 2017 to December 2017 in 102 cases of colon cancer diagnosed by surgery in QingDao Municipal Hospital with complete case and pathological data.The tumors were divided into two groups according to the tumor location,the left-sided colon cancer and the right-sided colon cancer.Immunohistochemistry method was used to detect the expression of MLH1,PMS2,MSH2 and MSH6 in colon cancer tissues.Recording the general data of patients,including gender,age,tumor size,tumor morphology,degree of differentiation,degree of infiltration,lymph node metastasis,RAS(K-RAS,N-RAS),BRAF V600 E gene mutation status and so on.Using SPSS 21 statistical software to analyze the data,unordered variables were analyzed by chi-square test or Fisher’s exact test,and ordered variables were analyzed by Kruskal-Wallish test.P <0.05 was considered statistically significant.Results:1.Among the 102 cases which were analysised,the left-sided colon group accounted for 46 cases,the right-sided colon group accounted for 56 cases.There were 28 males and 18 females in the left-sided colon group,31 males and 25 females in the right-sided colon group.The proportion of females in the right colon was greater than that in the left colon group(44.6% vs 42.2%),but the difference was not statistically significant(P> 0.05).2.In the left-sided colon group,32 cases were older than 60 years old,14 cases were under 60 years old.In the right-sided colon group,40 cases were over 60 years old and 16 cases were under 60 years old.Compared with the right colon group,patients in the left colon > 60 years of age had a lower proportion(69.6% vs 71.4%),but the difference was not significant difference(P> 0.05).3.Whether the left or right colon cancer,the general morphology of the tumor is the most common type of ulcerative type,followed by the protuberant type,the difference was not statistically significant(P> 0.05).4.Poorly differentiated were more common in the right-sided colon cancer,accounting for 16.1%,while high and moderately differentiated were more common in the left colon cancer,accounting for 93.5%,the difference was statistically significant(P <0.05).5.Compared with the left colon group,the number of lymph node metastases in the right colon group is more than 3(14.3% vs 4.3%),but the difference was not statistically significant(P> 0.05).6.The ratio of invading muscular layer to the right colon is larger than that in the left colon group(8.9% vs 4.3%),but the difference was not statistically significant(P> 0.05).7.In the left colon group,30 cases in limit stage,16 cases in advanced stage..In the right colon group,35 cases in limit stage and 21 cases in advanced stage.There was no significant correlation between tumor location and stage(P> 0.05).8.There were 25 cases of elevated CEA in the left colon and 33 cases of elevated CEA in the right colon group.The difference was not statistically significant(P> 0.05).9.There were 22 cases(78.6%)of K-RAS wild-type and 6 cases(21.4%)of K-RAS mutations in the left colon group,19 cases(54.3%)of K-RAS wild-type and 16 cases(45.7%)of K-RAS mutations in the right colon group.The tumor location was related to the K-RAS gene status.The mutation rate of K-RAS in the right colon was higher than that in the left colon cancer(P <0.05).10.There were 26 cases(92.9%)of N-RAS wild-type and 2 cases(7.1%)of N-RAS mutations in the left colon group,32(91.4%)of N-RAS wild-type and 8.6%in the right colon and 2 cases(8.6%)of N-RAS mutations in the right colon group,the difference was not statistically significant(P> 0.05).11.In the left colon group,there were 39 cases(95.1%)of BRAF V600 E wild-type and 2 cases(4.9%)of BRAF V600 E mutations.There were 47(90.4%)of BRAF V600 E wild-type and 5 cases(9.6%)of BRAF V600 E mutations in the right colon group.BRAF V600 E mutant in the right colon was more common than the left colon cancer(9.6% vs 4.9%),but the difference was not statistically significant(P> 0.05).12.The deficient rate of MLH1 and PSM2 protein was correlated with the location of tumor.The deletion rate of MLH1 and PSM2 protein in the right colon group was higher than that in the left colon group(P < 0.05).Compared with the right colon cancer,deficient mismatched repair gene(dMMR)are more common in right colon cancer(30.3% vs 6.5%,p=0.003).Conclusion:1.Differentiation of right colon cancer was worse than left colon cancer,tumor size of right colon cancer was larger than left colon cancer.2.Compared with the left colon cancer,K-RAS gene mutations was more common in right colon cancer.3.The deletion rate of MLH1 and PSM2 protein in the right colon cancer was higher than that in the left colon cancer,dMMR is more common in right colon cancer. |
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