Gastroenterology and Liver Services, Sydney South West Area Health Service, and Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
J Gastroenterol Hepatol. 2010 Jan;25(1):33-42. doi: 10.1111/j.1440-1746.2009.05992.x. Epub 2009 Oct 27.
Sex significantly influences the clinical and pathological characteristics of colorectal cancer (CRC). These include differences in incidence and mortality rates, clinical presentations including age, emergency surgery for complications from CRC, screening participation rates, site, stage and treatment utilization, histopathology and survival. Environmental, behavioral and biological factors contribute to the differential risk. Recent advances in the molecular biology of CRC, specifically in microsatellite status, estrogen hormone and estrogen receptor beta, have led to greater understanding of the effect of estrogen in colorectal carcinogenesis. Estrogen may preferentially protect against microsatellite unstable cancers through its effect on selected molecular targets; however, the exact pathways have not been elucidated. Recognition of important sex disparities in these areas may lead to the implementation of specific measures to diminish these differences and facilitate equitable distribution of health resources. Identifying specific molecular targets on CRC that interact with estrogen may stimulate research to improve the overall outcomes of all patients with CRC.
性别显著影响结直肠癌（CRC）的临床和病理特征。这些特征包括发病率和死亡率的差异、临床表现（包括年龄）、因 CRC 并发症而进行的急诊手术、筛查参与率、部位、分期和治疗利用、组织病理学和生存率。环境、行为和生物学因素促成了不同的风险。CRC 分子生物学的最新进展，特别是在微卫星状态、雌激素和雌激素受体β方面，使人们对雌激素在结直肠癌变中的作用有了更深入的了解。雌激素可能通过其对特定分子靶点的作用，优先保护微卫星不稳定的癌症；然而，确切的途径尚未阐明。认识到这些领域中重要的性别差异可能会导致采取具体措施来减少这些差异，并促进公平分配卫生资源。确定与雌激素相互作用的 CRC 上的特定分子靶标可能会刺激研究，以改善所有 CRC 患者的整体预后。
