Bienfait Lucie, Doukoure Brahima, Verset Laurine, Demetter Pieter
Service d'anatomie pathologique de l'hôpital Erasme (ULB), route de Lennik 808, 1070 Bruxelles, Belgique.
Service d'anatomie pathologique du CHU de Cocody, boulevard de l'Université, Abidjan, Côte d'Ivoire.
Ann Pathol. 2020 Jan;40(1):12-18. doi: 10.1016/j.annpat.2019.08.002. Epub 2019 Oct 9.
According to European and American series, up to 20% of colorectal cancers are characterised by instability at microsatellites sites. MMR deficient colorectal cancers are predominantly found in the right colon. Although an increasing rate of colorectal cancer has been observed in many low-income countries including in West-Africa, data on epidemiology and biology of colorectal cancer in native Africans from this region are scarce.
We aimed to study the incidence of MMR deficiency in Côte d'Ivoire and to compare the data with those from a tertiary center in Belgium. Immunohistochemistry for MLH1, MSH2, MSH6 and PMS2 was performed on paraffin-embedded tissue samples from 83 colorectal cancers (46% males) operated in Abidjan and from 343 colorectal cancers (53% males) from Brussels.
Colorectal cancer was occuring at a younger age in Côte d'Ivoire compared to Belgium (median age: 53 versus 66). MMR deficiency was detected in 11,7% of Belgian cases and in 13,3% of Ivorian cases. Whereas MMR deficient cancers in Brussels were mainly found in women (24/40 i.e. 60%), in Abidjan only 3/11 (27%) were female. Moreover, the predominant location of MMR deficient tumours was different between both series: in Brussels, mainly located in the right colon (24/40 i.e. 60%) whereas in Abidjan predominantly (10/11 i.e. 91%) in the left colon. In Brussels we observed in the majority of cases (67,5%) loss of expression of MLH1 and PMS2, in Abidjan loss of expression of MSH2 and MSH6 (54,5%).
Our pilot study reveals differences in presentation of MMR deficient colorectal cancer between the two geographic regions suggesting differences in epidemiology and biology of colorectal cancer in native Africans.
根据欧美的研究系列，高达20%的结直肠癌具有微卫星位点不稳定的特征。错配修复缺陷的结直肠癌主要发生在右半结肠。尽管在包括西非在内的许多低收入国家，结直肠癌的发病率一直在上升，但该地区非洲本土人群结直肠癌的流行病学和生物学数据却很稀少。
我们旨在研究科特迪瓦错配修复缺陷的发生率，并将数据与比利时一家三级中心的数据进行比较。对阿比让手术的83例结直肠癌（46%为男性）和布鲁塞尔的343例结直肠癌（53%为男性）的石蜡包埋组织样本进行MLH1、MSH2、MSH6和PMS2的免疫组织化学检测。
与比利时相比，科特迪瓦的结直肠癌发病年龄更年轻（中位年龄：53岁对66岁）。在比利时病例中，11.7%检测到错配修复缺陷，在科特迪瓦病例中为13.3%。布鲁塞尔错配修复缺陷的癌症主要见于女性（24/40，即60%），而在阿比让，只有3/11（27%）为女性。此外，两个系列中错配修复缺陷肿瘤的主要部位不同：在布鲁塞尔，主要位于右半结肠（24/40，即60%），而在阿比让主要位于左半结肠（10/11，即91%）。在布鲁塞尔，我们观察到大多数病例（67.5%）MLH1和PMS2表达缺失，在阿比让MSH2和MSH6表达缺失（54.5%）。
我们的初步研究揭示了两个地理区域错配修复缺陷结直肠癌表现的差异，提示非洲本土人群结直肠癌在流行病学和生物学上存在差异。
