Cannon-Albright L A, Thomas T C, Bishop D T, Skolnick M H, Burt R W
Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City.
Cancer. 1989 Nov 1;64(9):1971-5. doi: 10.1002/1097-0142(19891101)64:9<1971::aid-cncr2820640935>3.0.co;2-l.
Early age onset and proximal colonic location are two specific characteristics of colon cancer which have been used clinically to assess the risk that an individual case is of familial rather than sporadic origin. This practice derives from the observation that these characteristics are typical of the rare, nonpolyposis inherited colorectal cancer syndromes. This study examines these two characteristics in cases of common colon cancer to determine whether they actually distinguish individuals at increased risk for familial colorectal cancer. Familial clusters of colon cancer in the Utah Population Data Base were examined. Common colon cancers were found to cluster excessively in families; however, the measure of familial clustering for distal colonic cases was increased to the same degree as proximal colonic cases. Early age onset was likewise not a distinguishing factor of familial cases. These results suggest that factors other than those that predispose to the rare syndromes are important in determining familial risk for common colon cancers, and that the absence of these two clinical features should not suggest the absence of familial risk of colorectal cancer.
发病年龄早和近端结肠定位是结肠癌的两个特定特征，临床上已用其来评估个别病例是家族性而非散发性起源的风险。这种做法源于以下观察结果：这些特征是罕见的、非息肉病性遗传性结直肠癌综合征的典型特征。本研究在常见结肠癌病例中考察这两个特征，以确定它们是否真的能区分出患家族性结直肠癌风险增加的个体。对犹他州人口数据库中的结肠癌家族聚集情况进行了考察。发现常见结肠癌在家族中过度聚集；然而，远端结肠病例的家族聚集程度与近端结肠病例增加到相同程度。发病年龄早同样不是家族性病例的区分因素。这些结果表明，除了那些易患罕见综合征的因素外，其他因素在确定常见结肠癌的家族风险方面也很重要，而且这两个临床特征的缺失不应表明不存在结直肠癌的家族风险。
