Zahir Muhammad Nauman, Azhar Eisha Mahpara, Rafiq Sobia, Ghias Kulsoom, Shabbir-Moosajee Munira
Department of Oncology, Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan.
Department of Biological and Biomedical Sciences, Aga Khan University Hospital, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan.
ISRN Oncol. 2014 Apr 1;2014:461570. doi: 10.1155/2014/461570. eCollection 2014.
Background. Early onset colorectal carcinoma (CRC) is rare and has been hypothesized to be a biologically and clinically distinct entity personifying aggressive disease and worse survival. Methods. Data for 131 patients was collected by retrospective chart review. Cox proportional hazard model was used to compute prevalence ratios and 95% confidence intervals. Results. Early onset sporadic CRC accounted for 32% of all CRC treated in the specified time period. The mean age was 33.3 ± 7.9 years and the male to female ratio was 2 : 1. Colon and rectal cancers accounted for 55% and 45% of patients, respectively. 96% of rectal carcinoma patients received appropriate therapy as opposed to 65% of colon cancers. On multivariable analysis, appropriate reception of therapy (PR 4.99; 95% CI, 1.21-20.6) and signet ring morphology (PR 2.40; 95% CI, 1.33-4.32) were significantly associated with rectal cancers as opposed to colon cancer. Kaplan-Meier analysis revealed a trend towards inferior survival for rectal carcinoma 2 years after diagnosis. Conclusion.A high prevalence of early onset CRC was noted in the study. A trend towards inferior survival was seen in patients with rectal cancer. This finding raises the possibility of rectal carcinoma being an aggressive subset of young CRC.
背景。早发性结直肠癌（CRC）较为罕见，据推测是一种在生物学和临床上具有独特性的实体，代表着侵袭性疾病和较差的生存率。方法。通过回顾性病历审查收集了131例患者的数据。采用Cox比例风险模型计算患病率比值和95%置信区间。结果。早发性散发性CRC占特定时间段内所有接受治疗的CRC的32%。平均年龄为33.3±7.9岁，男女比例为2∶1。结肠癌和直肠癌患者分别占55%和45%。96%的直肠癌患者接受了适当治疗，而结肠癌患者这一比例为65%。多变量分析显示，与结肠癌相比，直肠癌与适当接受治疗（患病率比值4.99；95%置信区间，1.21 - 20.6）和印戒形态（患病率比值2.40；95%置信区间，1.33 - 4.32）显著相关。Kaplan - Meier分析显示，直肠癌患者在诊断后2年生存率有下降趋势。结论。该研究中早发性CRC的患病率较高。直肠癌患者生存率有下降趋势。这一发现增加了直肠癌是年轻CRC侵袭性亚组的可能性。
