Jiang Wu, Sui Qiao-Qi, Li Wen-Liang, Ke Chuan-Feng, Ling Yi-Hong, Liao Le-En, Zhu Zhu, Cai Mu-Yan, Luo Jun, Mao Lin-Lin, Zhang Hui-Zhong, Wan De-Sen, Pan Zhi-Zhong, Ju Hai-Xing, Ding Pei-Rong
Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China.
Department of Surgical Oncology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P. R. China.
Gastroenterol Rep (Oxf). 2020 Apr 10;8(5):399-403. doi: 10.1093/gastro/goaa006. eCollection 2020 Oct.
Although universal testing for mismatch repair deficiency (dMMR) has been recommended to all colorectal cancer (CRC) patients, related evidence for the Chinese population is lacking. Here, we investigated the prevalence and clinicopathological features of dMMR patients in a large Chinese CRC cohort.
We included 7,373 CRC patients treated at four Chinese medical centers between August 2010 and September 2016. Patients' baseline characteristics and pathological features were recorded. The clinicopathological features were compared between patients with MLH1/PMS2 deficiency (dMLH1/PMS2) and MSH2/MSH6 deficiency (dMSH2/MSH6).
Among the investigated patients, 654 (8.9%) were identified with dMMR CRCs and, of them, 401 (61.3%) were males, with a median age of 55 years (range, 22-87 years); 355 (54.3%) had stage II CRC based on American Joint Committee on Cancer 8th edition. The prevalence of the dMLH1/PMS2 group and the dMSH2/MSH6 group were 51.5% (337/654) and 25.1% (164/654), respectively. Compared with dMSH2/MSH6 patients, those with dMLH1/PMS2 were older (57 vs 52 years, <0.001), more likely to be female (45.7% vs 31.5%, =0.004), prone to having tumors located in the right-hand side of the colon (59.0% vs 47.6%, =0.015), and less likely to have a family history of tumors (29.7% vs 43.3%, =0.003).
The prevalence of dMMR in Chinese CRC patients was low, especially in the dMLH1/PMS2 group. The clinicopathological features were different between dMMR subgroups.
尽管已建议对所有结直肠癌(CRC)患者进行错配修复缺陷(dMMR)的普遍检测,但中国人群的相关证据仍很缺乏。在此,我们调查了一个大型中国CRC队列中dMMR患者的患病率及临床病理特征。
我们纳入了2010年8月至2016年9月期间在中国四个医疗中心接受治疗的7373例CRC患者。记录患者的基线特征和病理特征。比较了MLH1/PMS2缺陷(dMLH1/PMS2)患者和MSH2/MSH6缺陷(dMSH2/MSH6)患者的临床病理特征。
在被调查的患者中,654例(8.9%)被确诊为dMMR CRC,其中401例(61.3%)为男性,中位年龄为55岁(范围22 - 87岁);根据美国癌症联合委员会第8版,355例(54.3%)患有II期CRC。dMLH1/PMS2组和dMSH2/MSH6组的患病率分别为51.5%(337/654)和25.1%(164/654)。与dMSH2/MSH6患者相比,dMLH1/PMS2患者年龄更大(57岁对52岁,<0.001),女性比例更高(45.7%对31.5%,=0.004),更容易发生位于结肠右侧的肿瘤(59.0%对47.6%,=0.015),且有肿瘤家族史的可能性更小(29.7%对43.3%,=0.003)。
中国CRC患者中dMMR的患病率较低,尤其是在dMLH1/PMS2组。dMMR亚组之间的临床病理特征有所不同。