Real-world analysis of the differences between left and right colorectal cancer based on clinical pathologi-cal characteristics and gene testing results
Objective To investigate the heterogeneity between left-and right-sided colorectal cancer(CRC)in terms of clinical pathological features and gene expression,thereby providing a foundation for personalized treatment.Methods A retrospective analysis was conducted on the clinical data,next-generation sequencing(NGS)results,and treatment plans of 186 CRC patients treated at the forth hospital affiliated of guangxi medical university from July 2020 to August 2023.Patients were categorized into left-sided CRC(n=134)and right-sided CRC(n=52)based on tumor location.Clinical and pathological characteristics were analyzed using SPSS 24.0 software,and Kaplan-Meier survival curves were generated to compare overall survival(OS)between groups using the Log-rank test.Additionally,this study compared the clinical and pathological features,NGS-based gene mutation profiles,and prognostic differences between left-and right-sided CRC patients.Results In the clinical and patho-logical characteristics,no significant differences were observed between left-and right-sided CRC patients regarding gender,distant metastasis,ECOG performance status,TNM stage,or levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)(P>0.05).However,there were significant differences in age(P<0.05).In terms of gene mutation characteristics,the mutation frequencies of NRAS,BRAF,and APC genes did not differ significantly between left-and right-sided CRC patients(P>0.05).However,right-sided CRC patients exhibited significantly higher mutation frequencies of PIK3CA and SMAD4 genes,as well as a higher prevalence of microsat-ellite instability(MSI),compared to left-sided CRC patients(P<0.05).Conversely,left-sided CRC patients had significantly higher TP53 mutation frequencies than right-sided CRC patients(P<0.05).In prognostic analysis,af-ter a three-year follow-up,no significant difference in OS was observed between the two groups.Conclusions Significant disparities are observed in the clinical pathological features and gene expression profiles between left-and right-sided CRC.These findings indicate that distinct approaches should be adopted in clinical diagnosis and treatment to facilitate personalized and precise care.
万方数据
维普
