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[早发性结直肠癌]

[Early-onset Colorectal Cancer].

作者信息

Jeong Mo Ah, Kang Hyoun Woo

机构信息

Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.

出版信息

Korean J Gastroenterol. 2019 Jul 25;74(1):4-10. doi: 10.4166/kjg.2019.74.1.4.

Abstract

The incidence of colorectal cancer (CRC) is increasing among young adults in several countries including the United States. Early-onset colorectal cancer (EO-CRC) is heterogenous group and appears to have a distinct clinical, pathologic, and molecular presentation compared to CRC diagnosed in older patients. EO-CRC patients tend to be diagnosed at later stage and with symptomatic disease. Tumors arise predominantly in the distal colon and rectum and have poorer histological features. Microsatellite and chromosome stable molecular pathway is frequently observed in EO-CRC. Survival data of EO-CRC is conflicting and younger patients tend to be treated more aggressively. It is important to identify high risk and have them screened appropriately to address increasing EO-CRC. Screening and treatment strategies for EO-CRC should be developed through further investigation of molecular mechanism and various environmental risk factors. In Korea, EO-CRC and late-onset CRC have both declined in recent several years, probably due to many screening colonoscopies in young population. Close observation and analysis of EO-CRC in Korea is necessary.

摘要

包括美国在内的几个国家中,年轻人患结直肠癌(CRC)的发病率正在上升。早发性结直肠癌(EO-CRC)是一个异质性群体,与老年患者诊断出的CRC相比,似乎具有独特的临床、病理和分子表现。EO-CRC患者往往在疾病后期且出现症状时才被诊断出来。肿瘤主要发生在结肠远端和直肠,组织学特征较差。微卫星和染色体稳定分子途径在EO-CRC中经常被观察到。EO-CRC的生存数据存在矛盾,年轻患者往往接受更积极的治疗。识别高危人群并对其进行适当筛查以应对不断增加的EO-CRC很重要。应通过进一步研究分子机制和各种环境风险因素来制定EO-CRC的筛查和治疗策略。在韩国,近年来EO-CRC和晚发性CRC的发病率均有所下降,这可能是由于年轻人群中进行了大量的结肠镜筛查。有必要对韩国的EO-CRC进行密切观察和分析。

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