Clinical, morphological and laboratory investigation findings differences between the right and left sided colorectal cancer in a group of Bangladeshi patients

Auhtor: R Paul, M Kamal, F Begum, T Saha, T Talukdar

Abstract:

Background: Colorectal cancers (CRCa) are a global oncologic problem challenging physicians, surgeons and pathologists. A cross-sectional descriptive study was conducted among 35 cases of CRCa to see the clinical, morphological and investigation findings differences between right and left sided CRCa and loss of heterozygosity status in colonic cancer cells of these cases. Cancers arising from the left versus the right side of the colon have been shown to differ with respect to epidemiology, gross and morphology. Right sided colonic cancer (Rt.CC) patients were in younger age group, overweight and had smoking history. They had larger size, mostly exophytic type tumour that extended more up to pericolic fat. They commonly presented with abdominal pain. On the other hand left sided colonic cancer (Lt.CC) patients were in older age group, less overweight and smoking history, smaller sized, mostly ulcerating type tumour. Among the 30 cases of adenocarcinoma, 27 were left sided and only 3 were right sided. On the other hand only 5 (14.3%) were mucinous adenocarcinoma of which 2 were right sided and 3 were left sided. Poorly differentiated adenocarcinoma (1=20% vs 2=6.6%) and mucinous adenocarcinoma (2=40% vs 3=10%) were found more on right side compared to the left. Lt.CC had more lymphocytes infiltrating tumour. Rt.CC were mostly associated with ³50% extracellular mucin production. Lymphovascular invasion was found more in the Lt.CC compared to the right. Rt.CC were in more advance stage and high grade compared to the left side. Nodal metastasis in Rt.CC was more compared to that of left side.

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