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结直肠癌诊断时年龄的分子与临床病理差异

Molecular and Clinicopathological Differences by Age at the Diagnosis of Colorectal Cancer.

作者信息

Chang Chu-Cheng, Lin Pei-Ching, Lin Chun-Chi, Lan Yuan-Tzu, Lin Hung-Hsin, Lin Chien-Hsing, Yang Shung-Haur, Liang Wen-Yi, Chen Wei-Shone, Jiang Jeng-Kai, Lin Jen-Kou, Chang Shih-Ching

机构信息

Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan.

Department of Surgery, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan.

出版信息

Int J Mol Sci. 2017 Jul 5;18(7):1441. doi: 10.3390/ijms18071441.

Abstract

We compared the clinicopathological and molecular profiles between different age groups of sporadic colorectal cancer (CRC) patients (age <50, 56-60, 60-70, 70-80, and >80); 1475 CRC patients were enrolled after excluding 30 individuals with Lynch syndrome. The mutation spectra for , , , , , , , , , , and were analyzed using polymerase chain reaction (PCR), followed by MassArray and microsatellite (MSI-high) analysis by performing genotyping. Male patients (74.1%) were significantly predominant to females (25.9%) in the older age group (70-80, >80). There was an insignificantly linear trend between TNM staging and age-onset of CRC diagnosis. Patients aged < 50 had 58.7% diseases in the advanced stages (Stage III: 36.5% and IV: 22.2% respectively), while this decreased to 40.2% (Stage III: 26.2% and IV; 14.0% respectively) in patients >80. The distributions of mutation frequency were similar in majority of the genes studied among different age groups. Additionally, patients aged <50 had significantly higher frequency of MSI-high, , and mutations than those of other groups. Age-onset at diagnosis significantly affected overall survival (HR = 1.46; 95% CI: 1.35-1.58), but not cancer-specific survival (HR = 1.08; 95% CI: 0.99-1.18) in multivariate analysis. In conclusion, molecular and clinicopathological differences were not as significant among different age groups of CRC patients as previously suspected.

摘要

我们比较了散发性结直肠癌(CRC)患者不同年龄组(年龄<50岁、56 - 60岁、60 - 70岁、70 - 80岁和>80岁)之间的临床病理和分子特征;排除30例林奇综合征患者后,纳入了1475例CRC患者。使用聚合酶链反应(PCR)分析了 、 、 、 、 、 、 、 、 、 和 的突变谱,随后通过基因分型进行MassArray和微卫星(MSI高)分析。在老年组(70 - 80岁、>80岁)中,男性患者(74.1%)显著多于女性患者(25.9%)。TNM分期与CRC诊断的年龄发病之间存在不显著的线性趋势。年龄<50岁的患者中,36.5%处于III期、22.2%处于IV期,晚期疾病占58.7%;而在>80岁的患者中,这一比例降至40.2%(III期:26.2%,IV期:14.0%)。在不同年龄组研究的大多数基因中,突变频率分布相似。此外,年龄<50岁的患者中,MSI高、 和 突变的频率显著高于其他组。在多变量分析中,诊断时的年龄发病显著影响总生存期(HR = 1.46;95%CI:1.35 - 1.58),但不影响癌症特异性生存期(HR = 1.08;95%CI:0.99 - 1.18)。总之,CRC患者不同年龄组之间的分子和临床病理差异并不像之前怀疑的那么显著。

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