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Analysis of colorectal cancer morphology in relation to sex, age, location, and family history

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Abstract

Background

Studies of colorectal cancer (CRC) have suggested different mechanisms of carcinogenesis in men and women, young and old patients, right- and left sided tumors, and sporadic and familial tumors. These differences might be reflected in morphology.

Methods

CRCs from 1613 patients operated on in 2004–2006 in Sweden were histologically reviewed. Morphology was examined in relation to sex, age groups, location, and family history.

Results

Tumors in the right colon were larger, of higher stage, more often poorly differentiated, more mucin-producing, more often had a peritumoral lymphocytic infiltrate and a high level of tumor-infiltrating lymphocytes (TILs), and more seldom had an infiltrating margin than tumors in the left colon and rectum (p < 0.0001 for most features). Young patients (<60 years) more seldom had multiple tumors but more often had perineural invasion, an infiltrative tumor margin, and high-stage tumors. Three features, TILs, medullary tumors, and invasive tumor margin, were related to sex. Only vascular invasion was related to familiality.

Conclusion

Location is the factor that has the most influence on tumor morphology. The results support the idea that different carcinogenic mechanisms may be involved in the right and left colon. Age is the most important determinant for the presence of multiple tumors and is a crucial factor for the aggressiveness of the disease.

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Acknowledgments

We thank all patients and their spouses. We also thank Berith Wejderot for excellent technical assistance.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Pathology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, 14186, Stockholm, Sweden

    Sam Ghazi & Nikos Papadogiannakis

  2. Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, 17176, Stockholm, Sweden

    Ulrik Lindforss & Annika Lindblom

  3. Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, 14186, Stockholm, Sweden

    Greger Lindberg

  4. Medical Statistics Unit, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 17177, Stockholm, Sweden

    Elisabeth Berg

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  1. Sam Ghazi
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The Low-Risk Colorectal Cancer Study Group

Corresponding author

Correspondence to Sam Ghazi.

Additional information

The members of The Low-Risk Colorectal Cancer Study Group are listed in the Appendix.

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Supplementary Table 1 (DOC 73 kb)

Supplementary Table 2 (DOC 51 kb)

Appendix

Appendix

The members of the Low-Risk Colorectal Cancer Study Group are: David Edler, Karolinska Universitetssjukhuset/Solna (Stockholm); Claes Lenander, Mag-tarm-centrum, Ersta sjukhus (Stockholm); Johan Dalén, S:t Görans sjukhus (Stockholm); Fredrik Hjern, Danderyds sjukhus (Danderyd); Nils Lundqvist, Norrtälje sjukhus (Norrtälje); Ulrik Lindforss, Södertälje sjukhus (Södertälje); Lars Påhlman, Akademiska sjukhuset (Uppsala); Kennet Smedh, Centrallasarettet (Västerås); Anders Törnqvist, Centralsjukhuset (Karlstad); Jörn Holm, Länssjukhuset Gävle-Sandviken (Gävle); Martin Janson, Karolinska Universitetssjukhuset/Huddinge (Huddinge); Magnus Andersson, Universitetssjukhuset (Örebro); Susanne Ekelund, Södersjukhuset (Stockholm); and Louise Olsson, Mälarsjukhuset (Eskilstuna).

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Ghazi, S., Lindforss, U., Lindberg, G. et al. Analysis of colorectal cancer morphology in relation to sex, age, location, and family history. J Gastroenterol 47, 619–634 (2012). https://doi.org/10.1007/s00535-011-0520-9

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  • DOI: https://doi.org/10.1007/s00535-011-0520-9

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