中间型结直肠癌:早发型和晚发型结直肠癌之间的临床和家族界限。

Intermediate-onset colorectal cancer: A clinical and familial boundary between both early and late-onset colorectal cancer.

机构信息

Department of Clinical Biochemistry, "Gregorio Marañón" University Hospital, Madrid, Spain.

Department of Surgery, "12 de Octubre" University Hospital, Madrid, Spain.

出版信息

PLoS One. 2019 May 16;14(5):e0216472. doi: 10.1371/journal.pone.0216472. eCollection 2019.

Abstract

Comparative studies of colorectal cancer (CRC) according to the age of onset have found differences between early-onset CRC (EOCRC) and late-onset CRC (LOCRC). Using this as a starting point, we wished to determine whether intermediate-onset CRC (IOCRC) might also be considered as an independent group within CRC. We performed a retrospective comparative study of the clinicopathological and familial features, as well as of the symptoms and their duration, of a total of 272 subjects diagnosed with CRC classified into three groups according to the age-of-onset (98 EOCRC, 83 IOCRC and 91 LOCRC). The results show that from a clinicopathological point of view, IOCRC shared certain features with EOCRC (gender, prognosis), and with LOCRC (multiple primary CRCs), whereas it also had characteristics that were specific for IOCRC (mean number of associated polyps). A gradual progression was observed from EOCRC to LOCRC from a greater family aggregation to sporadic cases, in parallel with a change of Lynch Syndrome cases to the sporadic microsatellite instability pathway, with the IOCRC being a boundary group that is more related to EOCRC. With respect to symptoms, duration and correlation with stages, IOCRC appeared more similar to EOCRC. Clinically, IOCRC behaves as a transitional group between EOCRC and LOCRC, with features in common with both groups, but also with IOCRC-specific features. Excluding cases with familial cancer history, the awareness for EOCRC diagnosis should be extended to IOCRC.

摘要

比较不同发病年龄结直肠癌(CRC)的研究发现,早发性 CRC(EOCRC)和晚发性 CRC(LOCRC)之间存在差异。基于此,我们希望确定中间发病 CRC(IOCRC)是否也可被视为 CRC 的一个独立亚组。我们对总共 272 名根据发病年龄(98 例 EOCRC、83 例 IOCRC 和 91 例 LOCRC)分为三组的 CRC 患者的临床病理和家族特征,以及症状及其持续时间进行了回顾性比较研究。结果表明,从临床病理角度来看,IOCRC 与 EOCRC(性别、预后)和 LOCRC(多发原发性 CRC)具有某些共同特征,而与 IOCRC 特有的特征(相关息肉的平均数量)。从 EOCRC 到 LOCRC,家族聚集性逐渐增加到散发性病例,同时 Lynch 综合征病例转变为散发性微卫星不稳定性途径,IOCRC 是一个与 EOCRC 更相关的边界组。就症状、持续时间和与分期的相关性而言,IOCRC 与 EOCRC 更为相似。临床上,IOCRC 是 EOCRC 和 LOCRC 之间的过渡组,与两组都有共同特征,但也有 IOCRC 特有的特征。如果排除家族性癌症病史的病例,EOCRC 的诊断意识应扩展到 IOCRC。

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