Wu Chew-Wun, Chen Ming-Huang, Huang Kuo-Hung, Chang Shih-Ching, Fang Wen-Liang, Lin Chien-Hsing, Chao Yee, Lo Su-Shun, Li Anna Fen-Yau, Shyr Yi-Ming
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Aging (Albany NY). 2020 Aug 18;12(18):18137-18150. doi: 10.18632/aging.103627.
Few reports have investigated different genetic alterations according to age in various cancers. In total, 1749 GC patients receiving curative surgery were enrolled. The clinicopathological features, and prognoses were compared between younger (<65 years) and older (≥65 years) patients. Genetic mutations were analyzed using mass spectrometric single nucleotide polymorphism genotyping technology, including 68 validated mutations within eight genes (, , , and the pathway) previously reported in relation to age. Younger patients were more likely to be female and have poor cell differentiation, diffuse-type tumors, less lymphovascular invasion, fewer liver metastases, and better 5-year overall survival (OS) (68.0% vs. 54.6%, <0.001) and disease-free survival (DFS) (65.4% vs. 53.0%, <0.001) rates than older patients. Regarding the genetic alterations, older patients had more microsatellite instability-high (MSI-H) tumors and more mutations than younger patients. Younger patients had significantly better OS and DFS rates than older patients for each pathological Tumor, Node, Metastasis (TNM) stage. Older patients had a significantly higher non-cancer related death rate than younger patients (36.2% vs. 12.3%, <0.001). Age was an independent prognostic factor in GC. In conclusion, age was associated with different clinicopathological features and genetic alterations in GC with curative surgery.
很少有报告根据年龄对各种癌症的不同基因改变进行研究。总共纳入了1749例接受根治性手术的胃癌患者。比较了年轻（<65岁）和老年（≥65岁）患者的临床病理特征和预后。使用质谱单核苷酸多态性基因分型技术分析基因突变，包括先前报道的与年龄相关的八个基因（、、和通路）中的68个已验证突变。年轻患者更可能为女性，细胞分化差，肿瘤为弥漫型，较少发生淋巴血管侵犯，肝转移较少，5年总生存率（OS）（68.0%对54.6%，<0.001）和无病生存率（DFS）（65.4%对53.0%，<0.001）高于老年患者。关于基因改变，老年患者的微卫星高度不稳定（MSI-H）肿瘤和突变比年轻患者更多。对于每个病理肿瘤、淋巴结、转移（TNM）分期，年轻患者的OS和DFS率均显著优于老年患者。老年患者的非癌症相关死亡率显著高于年轻患者（36.2%对12.3%，<0.001）。年龄是胃癌的独立预后因素。总之，年龄与接受根治性手术的胃癌患者的不同临床病理特征和基因改变相关。
