Histopathological Evaluation of Right and Left Sided Colorectal Cancer: A Cross-sectional Study from a Tertiary Care Hospital, Assam, India
EC32-EC35
Correspondence
Dr. Gautam Boro,
House No. 12c, Adarsapur Lane 1, Near Sai RNS Academy, Kahilipara, Guwahati-781019, Assam, India.
E-mail: dr.gautam27boro@gmail.com
Introduction: Colorectal cancer is a heterogeneous disease that can develop in any part of the colon including rectum, with significant differences in clinical features and survival of patient in right sided and left sided colorectal carcinoma. Hence, it is necessary to evaluate the pathological characteristics of these tumour.
Aim: To analyse the pathological features of patients with right and left sided colorectal cancer.
Materials and Methods: This hospital-based, cross-sectional study conducted in Department of Pathology at Assam Medical College, Dibrugarh, Assam, India, from July 2019 to June 2020. The study included 35 cases of all endoscopic biopsy specimens and surgically excised large specimens of carcinomatous growths of colon and rectum, whereas carcinoma of appendix was excluded from this study. Special stain like Periodic Acid Schiff (PAS) and Alcian Blue, and immunohistochemistry (CK7 and CK20) was done in selected cases. The data is shown in tables and results are expressed in terms of frequency and percentages.
Results: Left colon (74.28%) was more commonly involved than right colon (25.72%) and rectum was the most common site (31.43%). The most common gross morphology in right colon was ulcerative growth (16%) and in left colon it was polypoidal growth (28%). On histopathological examination, 27 cases were adenocarcinoma, Not Otherwise Specified (NOS) (six were well differentiated, 20 were moderately differentiated and one was poorly differentiated) and eight cases were mucinous adenocarcinoma. The mean age was 51.54 years with age distribution from 14 years to as old as 80 years. In immunohistochemistry, 9 (90%) cases show CK20 positive/CK7 negative and 1 (10%) case show CK20 positive/CK7 focally positive.
Conclusion: Routine microscopic examination of haematoxylin and eosin stained slide was still the commonly performed and vital modality of investigation in majority of the cases. The right and left sided colorectal carcinoma varies according to clinical and pathological features. However, it is still necessary to find other biological dissimilarities of adenocarcinoma located on different sides of colon.