Ann Coloproctol.  2019 Dec;35(6):342-346. 10.3393/ac.2019.03.17.1.

Immunological Differences Between Right-Sided and Left-Sided Colorectal Cancers: A Comparison of Embryologic Midgut and Hindgut

Affiliations
  • 1Department of Surgery, Chonnam National University Hospital, Gwangju, Korea. galaxy9135@naver.com

Abstract

PURPOSE
There are known differences in embryology, clinical symptoms, incidences, molecular pathways involved, and oncologic outcomes of right-sided and left-sided colorectal cancers. However, immunologic study has only been characterized for healthy adults. The present study was designed to identify differences in immune cell populations in patients with right-sided and left-sided colorectal cancers.
METHODS
A total of 35 patients who underwent colorectal resection for cancer between November 2016 and August 2017 at a tertiary teaching hospital were enrolled in this study. Patients were excluded if they had a disease affecting their immune system. Populations of immune cells, including mucosal-associated invariant T (MAIT), gamma delta T, invariant natural killer T, T, natural killer, and B cells, were measured in the peripheral blood and cancer tissues using flow cytometry, and then assessed based on the origin of the colorectal cancer.
RESULTS
Fifteen had right-side and 20 had left-side colorectal cancer. There were no significant differences between the 2 cohorts for patient characteristics including pathologic stage. Peripheral blood from patients with right-side colon cancers contained fewer MAIT (0.87% right-side vs. 1.74% left-side, P = 0.028) and gamma delta T cells (1.10% right-side vs. 3.05% left-side, P = 0.002). Although the group with right-side colorectal cancer had more MAIT cells in cancer tissues (1.71% vs. 1.00%), this difference was not statistically significant.
CONCLUSION
There is a difference in population sizes of immune cells in blood between patients with right-sided and leftsided colon cancers. The immune cell composition was determined to be distinct based on embryologic origin.

Keyword

Colorectal cancer; Embryology; Sidedness; Immune cell

MeSH Terms

Adult
B-Lymphocytes
Cohort Studies
Colonic Neoplasms
Colorectal Neoplasms*
Embryology
Flow Cytometry
Hospitals, Teaching
Humans
Immune System
Incidence
Population Density
T-Lymphocytes
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