| Background and Objective:Colorectal carcinoma(CRC)is one of the common malignant tumors,and the incidence and mortality rates have shown an upward trend in recent years,which seriously threatens human life and health.Colorectal cancer refers to malignant epithelial tumors that originate in the colon or rectum,also known as colorectal cancer,which can be divided into left-side colorectal cancer(LCC)and right-side colorectal cancer(RCC)according to different anatomical sites.According to the latest data released by WHO’s Research Agency on Cancer in 2020,colorectal cancer incidence and mortality rates are among the highest of all cancer species globally,and there are high morbidity and mortality rates in both men and women.With the deepening of scientific research,scholars have gradually discovered that there are significant differences in LCC and RCC in many aspects such as epidemiology,clinical characteristics,degree of tumor differentiation,and response to treatment.Therefore,many scholars believe that LCC and RCC should be regarded as two different diseases.To provide reference for the diagnosis,treatment and prevention of left and right colorectal cancer,the difference analysis of clinical and pathological features and immunohistochemistry(IHC)、bioinformatics was made.Methods:1.Retrospective clinical data analysis was adopted,and then Chi-square test was carried out(P<0.05).2.Download transcriptome data and clinical information data of colorectal cancer in the Cancer Genome Atlas(TCGA)database,use the R software package for differential analysis to screen out the differential genes of left and right half colorectal cancer,and perform gene ontology(GO)analysis of differential expression of mRNAs and kyoto encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.Results:1.Terms of basic information,First,there are differences in age distribution(P<0.05).Patients with left and right colorectal cancer tend to occur in middle-aged and elderly people:patients with left colorectal cancer(LCC)are mainly concentrated in the 40-60 age group,and patients with right colorectal cancer(RCC)are mostly over 60 years old;Secondly,there are differences in gender distribution:the proportion of men in LCC patients is significantly higher than that of women,while the majority of RCC cancer patients are women.There were significant differences between the two groups(P<0.001).2.First symptom,A total of 200 research samples were selected in this study,all of which were patients with large intestine(CRC),among which 87 cases had the most blood as the first symptom,of which 71 cases were LCC and 16 cases were RCC,accounting for 62.28%and 18.60%respectively.Followed by abdominal pain,a total of 56 cases,of which 16 cases were LCC and 40 cases were RCC,accounting for 14.04%and 46.51%respectively;There were 27 cases with changes in stool properties,of which 21 cases were LCC and 6 cases were RCC,accounting for 18.42%and 6.98%respectively.30 cases showed abdominal mass,among which 6 cases were LCC and 24 cases were RCC,accounting for 5.26%and 27.91%respectively.To sum up,the first symptoms of LCC are mainly bloody stool and stool property change,accounting for 62.28%and 18.42%respectively;The first symptoms of RCC were abdominal pain and palpable abdominal mass,accounting for 46.51%and 27.91%respectively.There were significant differences between the two groups(P<0.01).3.Clinical staging,In Dukes A patients,there were 28 cases of LCC and 8 cases of RCC,accounting for 24.56%and 9.30%respectively.Among Dukes B patients,there were 33 cases of LCC and 34 cases of RCC,accounting for 28.95%and 39.53%respectively.In DukesC patients,there were 42 cases of LCC and 24 cases of RCC,accounting for 36.84%and 27.91%respectively.Among patients in DukesD stage,there were 11 cases of LCC and 20 cases of RCC,accounting for 9.65%and 23.26%respectively.By comparison,it showed that the proportion of LCC and RCC in the fourth stage patients was statistically significant(P<0.01).To sum up,most patients in Dukes A and C stage are LCC,and most patients in D stage are RCC.4.Pathological types,In poorly differentiated adenocarcinoma,there were 8 cases and 18 cases in the left and right half groups,accounting for 7.02%and 20.93%respectively,P=0.016;In the middle differentiated adenocarcinoma,there were 82 cases in the left and 37 cases in the right half group,accounting for 71.93%and 43.02%respectively,P=0.005.In terms of vascular invasion,there were 4 cases and 18 cases in the left and right half groups,accounting for 3.51%and 20.93%respectively,P=0.005.In terms of the number of lymph nodes removed by surgery(12 as the standard),84 cases were in the left and 79 cases in the right half group,accounting for 73.68%and 91.86%respectively,P=0.014.However,there was no significant difference between the two groups in the aspects of tumor maximum diameter,gross characteristics,nerve invasion and well-differentiated adenocarcinoma.5.Tumor markers,In the change of CA125 level,19 cases and 31 cases in the left and right half groups exceeded the normal value,accounting for 16.67%and 36.05%respectively,P=0.002;In terms of anemia,there were 40 cases and 44 cases in the left and right half groups,accounting for 35.09%and 51.16%respectively,P=0.023;In the positive aspect of fecal occult blood,there were 59 cases and 61 cases in the left and right groups,accounting for 51.75%and 70.93%respectively,P=0.006.6.Immunohistochemistry,In Her-2 test,114 samples and 86 samples were tested in the left and right half groups,and 16 samples and 24 samples were positive,accounting for 14.04%and 27.91%respectively,P=0.015,the difference between groups was statistically significant.7.Bioinformatics analysis,CRC transcriptome analysis showed that the differential genes were mainly enriched in biological(BP)processes such as transmembrane transport of cell ions,system regional regulation,hormone metabolism and endocrine processes.In terms of cell composition(CC),differential genes are mainly concentrated in the apex of the cytoplasmic membrane and the extracellular matrix;In terms of molecular function(MF),differential genes are mainly enriched in DNA-binding transcriptional activator activity,activity of water transmembrane transporters,etc.In terms of KEGG enrichment function,the differential genes are mainly enriched in pathways such as pancreatic secretion,renin-angiotensin system,bile secretion,and retinol metabolism.Conclusion:1.Middle-aged and elderly people are high-risk groups of CRC,most of them are middle-aged people,and most of them are elderly people.The LCC is mostly male,while the RCC is mostly female.2.Blood in stool is the first symptom of most LCC patients,and abdominal pain or abdominal mass is the first symptom of most RCC patients.In CA125 level,RCC was significantly higher than LCC,and the prognosis was poor.3.Dukes A stage patients account for a higher proportion in the left colorectal cancer,while Patients with RCC are mostly DukesD stage.4.Most patients with LCC are highly differentiated adenocarcinoma,while most patients with RCC are moderately differentiated adenocarcinoma.Compared with RCC,the number of lymph nodes removed after LCC is less,the positive rate of Her-2 is lower,lymph node metastasis and vascular invasion are less.5.There are different genes between LCC and RCC,which are mainly enriched in functions such as ion transmembrane transport,system regional regulation,endocrine and hormone metabolism.It is also enriched in pathways such as pancreatic secretion,renin-angiotensin system,bile secretion,and retinol metabolism. |
PDF Full Text Request