Analysis On The Difference Of Clinicopathological Features Of Colon Cancer In Different Sites Of Yanbian In Northeast China

Objective:To analyze the difference of clinicopathological features in different sites of colon cancer,which provided reference for clinical diagnosis and individualized therapy of colon cancer.Methods:Data of 463 patients who performed colon cancer operation and were pathologically verified to be colon cancer in the Gastrointestinal Surgery Department of Yanbian University Hospital from January 2016 to September 2020 were collected.Colon cancer was segmented into four groups by different sites,namely ascending colon cancer group(including cecal cancer and ascending colon cancer,121 cases),transverse colon cancer group(including liver curve cancer and transverse colon cancer,68 cases),descending colon cancer group(including spleen curved cancer and descending colon cancer,59 cases)and sigmoid colon cancer group(including only sigmoid colon cancer,215 cases).Comparing and analyzing the clinical data,initial clinical feature,pathological features and immuno-histochemical results of colon cancer patients among all groups,to assess the difference of clinico-pathological characteristics in different sites of colon cancer.Results:1.There were no statistical differences in the sex,age,ethnicity and timing of operation among all groups(all P>0.05).2.The initial clinical feature of each group of patients:the abdominal symptoms,abdominal masses,intestinal obstruction,blood in the stool and changes in bowel habits have statistical differences among the groups(all P<0.05),but the physical examination findings and fatigue have not statistical differences among the groups(all P>0.05).3.The pathological features of colon cancer in each group:the gross morphology,tumor diameter,tissue type,degree of differentiation,vascular tumor thrombus,mucus secretion,and tumor tissue necrosis have statistical differences among the groups(all P<0.05),but the distant metastasis and nerve infiltration have not statistical differences among the groups(all P>0.05).4.An average of 14 lymph node dissections for colon cancer,an average of 17 free lymph nodes in the ascending colon cancer group,16 in the transverse colon cancer group,12 in the descending colon cancer group,12 in the sigmoid colon cancer group,ascending colon cancer group,transverse colon cancer group and descending colon cancer group has statistical difference(P<0.05),ascending colon cancer group,transverse colon cancer group and sigmoid colon cancer group has statistical difference(P<0.05);The number of lymph node metastasis and metastasis rate have not statistical differences among the groups(all P>0.05);There was a significant negative correlation between the number of free lymph nodes and tumor diameter in ascending colon cancer group(r_s=-0.233,P<0.05),the number of lymph node metastasis in transverse colon cancer group(r_s=0.254),descending colon cancer group(r_s=0.281)and sigmoid colon cancer group(r_s=0.337)was significantly positively correlated with tumor diameter(all P<0.05).The TNM staging and total clinical staging have not statistical differences among the groups(all P>0.05).The tumor markers CEAand CA125 positive rates have not statistical differences among the groups(all P>0.05),but the CA199 positive rates has statistical difference among the groups(P<0.05).5.Colon cancer immunohistochemical results:In colon cancer,complete mismatch repair(MMR)protein expression(p MMR)accounted for 80.6%(n=373),and lack of expression(d MMR)accounted for 19.4%(n=90).Among them,the single protein d MMR was mainly PMS2(n=83),17.9%),combined d MMR was more common in MLH1/PMS2(n=56,12.1%).The expression status of MMR protein and ki-67 index in each group were statistical differences in colon cancer(all P<0.05);MMR protein contains four specific proteins related to colon cancer,the expression status of MLH1,MSH6 and PMS2 have statistical differences among the groups(all P<0.05),but the expression status of MSH2 has not statistical difference among the groups(P>0.05).Conclusion:1.All groups of colon cancer were more common in abdominal symptoms.The closer the tumor site was to the anus,the more typical symptoms,such as changes in bowel habits and intestinal obstruction.2.The closer the tumor site is to the cecum,the higher the proportion of mucinous adenocarcinoma/signet ring cell carcinoma,and the lower the proportion of adenocarcinoma(non-special type);compared with other groups,the ascending colon cancer group has a higher proportion of poorly differentiated and is more likely to have mucus Vascular tumor thrombi were secreted and occurred,and the number of free lymph nodes was also larger,the least in the sigmoid colon cancer group.3.The positive rate of serum CA199 was different among all groups,and the positive rate of CA199 was the highest in transverse colon cancer group.The jointed detection of CEA and CA199is more meaningful in the diagnosis of colon cancer,and more suitable for transverse colon cancer group.Compared with other groups,the proportion of d MMR in ascending colon cancer group was the highest.The farther the tumor was from the cecum,the higher the proportion of high expression rate of Ki-67 index was.