Aparicio Thomas, Schischmanoff Olivier, Poupardin Cecile, Mary Florence, Soufir Nadem, Barrat Christophe, Bellaiche Guy, Boubaya Marouane, Choudat Laurence, Cucherousset Joel, DesGuetz Gaetan, Wind Philippe, Benamouzig Robert
Gastroenterology, Avicenne Hospital, APHP, HUPSSD, Sorbonne-Paris Cité, University Paris 13, Bobigny, France.
Biochemistry, Avicenne Hospital, APHP, HUPSSD, Sorbonne-Paris Cité, University Paris 13, Bobigny, France.
J Geriatr Oncol. 2014 Oct 1;5(4):384-8. doi: 10.1016/j.jgo.2014.08.002. Epub 2014 Aug 28.
Colorectal cancer (CRC) occurs mostly in the elderly. However, the biology of CRC in elderly has been poorly studied. This study examined the prevalence of deficient mismatch repair phenotype (dMMR) and BRAF mutations according to age.
MMR phenotype was prospectively determined by molecular analysis in patients of all ages undergoing surgery for CRC. BRAF V600E mutation status was analysed in a subset of dMMR tumours.
A total of 754 patients who underwent surgery between 2005 and 2008 were included in the study. Amongst them, 272 (36%) were ≥75years old. The proportion of women <75 was 38% and that ≥75 was 53% (p<0.0001). The prevalence of dMMR was 19.4% in patients ≥75 and 10.7% in patients <75 (p=0.0017). For patients ≥75, the prevalence of dMMR was significantly higher in women than in men (27% vs 10.2%, respectively; p=0.003) but was similar in women and men <75 (12.5% vs 9.7%, respectively; p=0.4). We examined BRAF mutation status in 80 patients with dMMR tumours. The V600E BRAF mutation was significantly more frequent in patients ≥75 than in patients <75 (72.2% vs 11.4%, respectively; p<0.001). In patients ≥75, there was no difference in the prevalence of the BRAF V600E mutation according to sex (78% in women and 70% in men, p=0.9).
The prevalence of dMMR in CRC is high in patients over 75. In elderly patients, dMMR tumours are significantly more frequent in women than in men. The BRAF mutation is frequent in elderly patients with CRC.
结直肠癌（CRC）大多发生于老年人。然而，老年CRC的生物学特性研究较少。本研究根据年龄检测错配修复缺陷表型（dMMR）和BRAF突变的发生率。
对所有接受CRC手术的各年龄段患者，通过分子分析前瞻性确定MMR表型。在一部分dMMR肿瘤患者中分析BRAF V600E突变状态。
共有754例在2005年至2008年间接受手术的患者纳入本研究。其中，272例（36%）年龄≥75岁。年龄<75岁的女性比例为38%，年龄≥75岁的女性比例为53%（p<0.0001）。年龄≥75岁患者中dMMR的发生率为19.4%，年龄<75岁患者中为10.7%（p=0.0017）。对于年龄≥75岁的患者，女性dMMR的发生率显著高于男性（分别为27%和10.2%；p=0.003），但年龄<75岁的女性和男性相似（分别为12.5%和9.7%；p=0.4）。我们检测了80例dMMR肿瘤患者的BRAF突变状态。年龄≥75岁患者中V600E BRAF突变显著高于年龄<75岁患者（分别为72.2%和11.4%；p<0.001）。在年龄≥75岁的患者中，BRAF V600E突变的发生率根据性别无差异（女性为78%，男性为70%，p=0.9）。
75岁以上CRC患者中dMMR的发生率较高。在老年患者中，dMMR肿瘤在女性中显著多于男性。BRAF突变在老年CRC患者中很常见。
