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中国遗传性非息肉病性结直肠癌的表型分析。

Analysis for phenotype of HNPCC in China.

作者信息

Song Yong-Mao, Zheng Shu

机构信息

Department of Oncology, 2nd Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.

出版信息

World J Gastroenterol. 2002 Oct;8(5):837-40. doi: 10.3748/wjg.v8.i5.837.

Abstract

AIM

The aims of this study were to identify the clinicopathological features of Chinese HNPCC families and to evaluate the value of criteria for suspected HNPCC (sHNPCC) in clinical diagnosis.

METHODS

According to the follow-up records, 54 HNPCC families (including 12 ICG-HNPCC families and 42 sHNPCC families) were screened out from patients with colorectal cancers (CRCs), operated upon in 2(nd) Affiliated Hospital of Zhejiang University from 1984 to 2001. Clinical data of probands and tumor spectrum in these families were listed and analyzed.

RESULTS

(1) Mean age, proportion of colonic cancer, poorly differentiated cancer, multiple CRCs and Dukes' A+B of the probands in ICG-HNPCC and sHNPCC kindred were 39ys and 47.5ys, 75 % and 62 %, 0 and 12.8 %, 16.7 % and 14.3 %, 58.3 % and 81 %,respectively. Compared with sporadic colorectal cancers, probands from ICG-HNPCC and sHNPCC families were obviously different at age of onset (P=0.025 and 0.031), tumor location (P=0.001 and 0.000), differentiation(P=0.002 and 0.011) and development of multiple tumors (P=0.014 and 0.002). (2) A total of 178 malignant neoplasms were found in 54 HNPCC families, including 139 colorectal cancers. Besides of colorectal cancer, extracolonic tumors occurred in stomach, endometrium, hepatobiliary system, and so on (8 gastric cancers, 6 endometrial cancers, 6 hepatobiliary system cancers and 19 others) can also be seen in Chinese ICG-HNPCC and sHNPCC families.

CONCLUSION

(1) Chinese HNPCC families have specific clinicopathological features, such as early onset, predilection for the involvement of colon, tendency of multiple CRCs, development of extracolonic tumors and well differentiation. (2) The criteria for suspected HNPCC is useful in clinical diagnosis and management of HNPCC.

摘要

目的

本研究旨在明确中国遗传性非息肉病性结直肠癌(HNPCC)家系的临床病理特征,并评估疑似HNPCC(sHNPCC)诊断标准在临床诊断中的价值。

方法

根据随访记录,从1984年至2001年在浙江大学医学院附属第二医院接受手术治疗的结直肠癌患者中筛选出54个HNPCC家系(包括12个国际遗传性结直肠癌协作组(ICG)-HNPCC家系和42个sHNPCC家系)。列出并分析这些家系中先证者的临床资料和肿瘤谱。

结果

(1)ICG-HNPCC和sHNPCC家系中先证者的平均年龄、结肠癌比例、低分化癌比例、多发结直肠癌比例及Dukes'A+B期比例分别为39岁和47.5岁、75%和62%、0和12.8%、16.7%和14.3%、58.3%和81%。与散发性结直肠癌相比,ICG-HNPCC和sHNPCC家系的先证者在发病年龄(P=0.025和0.031)、肿瘤部位(P=0.001和0.000)、分化程度(P=0.002和0.011)及多发肿瘤发生情况(P=0.014和0.002)方面存在明显差异。(2)在54个HNPCC家系中共发现178例恶性肿瘤,其中结直肠癌139例。在中国ICG-HNPCC和sHNPCC家系中,除结直肠癌外,还可见胃、子宫内膜、肝胆系统等部位的结外肿瘤(8例胃癌、6例子宫内膜癌、6例肝胆系统癌及19例其他肿瘤)。

结论

(1)中国HNPCC家系具有特定的临床病理特征,如发病早、结肠受累倾向、多发结直肠癌趋势、结外肿瘤发生及高分化等。(2)疑似HNPCC诊断标准对HNPCC的临床诊断和管理具有重要价值。

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