Division of Anatomical Pathology, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, National Health Laboratory Services, Johannesburg, 2193, South Africa.
Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, National Health Laboratory Services, Braamfontein, Johannesburg, 2000, South Africa.
BMC Cancer. 2022 Oct 24;22(1):1089. doi: 10.1186/s12885-022-10185-3.
A large proportion of indigenous African (IA) colorectal cancer (CRC) patients in South Africa are young (< 50 years), with no unique histopathological or molecular characteristics. Anatomical site as well as microsatellite instability (MSI) status have shown to be associated with different clinicopathological and molecular features. This study aimed to ascertain key histopathological features in microsatellite stable (MSS) and low-frequency MSI (MSI-L) patients, to provide insight into the mechanism of the disease.
A retrospective cohort (2011-2015) of MSS/MSI-L CRC patient samples diagnosed at Charlotte Maxeke Johannesburg Academic Hospital was analyzed. Samples were categorized by site [right colon cancer (RCC) versus left (LCC)], ethnicity [IA versus other ethnic groups (OEG)] and MSI status (MSI-L vs MSS). T-test, Fischer's exact and Chi-square tests were conducted.
IA patients with LCC demonstrated an increased prevalence in males, sigmoid colon, signet-ring-cell morphology, MSI-L with BAT25/26 marker instability and advanced disease association.
This study revealed distinct histopathological features for LCC, and suggests BAT25 and BAT26 as negative prognostic markers in African CRC patients. Larger confirmatory studies are recommended.
南非很大一部分非洲原住民（IA）结直肠癌（CRC）患者较为年轻（<50 岁），并无独特的组织病理学或分子特征。解剖部位以及微卫星不稳定性（MSI）状态与不同的临床病理和分子特征相关。本研究旨在确定微卫星稳定（MSS）和低频微卫星不稳定（MSI-L）患者的关键组织病理学特征，以深入了解疾病的发病机制。
对夏洛特·马克西姆约翰内斯堡学术医院（Charlotte Maxeke Johannesburg Academic Hospital）于 2011 年至 2015 年期间诊断出的 MSS/MSI-L CRC 患者样本进行回顾性队列研究。根据部位[右结肠癌（RCC）与左结肠癌（LCC）]、种族[非洲原住民（IA）与其他种族群体（OEG）]和 MSI 状态（MSI-L 与 MSS）对样本进行分类。采用 T 检验、Fisher 确切检验和卡方检验进行数据分析。
LCC 的 IA 患者中男性、乙状结肠、印戒细胞形态、MSI-L 伴 BAT25/26 标志物不稳定以及疾病晚期的比例更高。
本研究揭示了 LCC 具有独特的组织病理学特征，并提示 BAT25 和 BAT26 是非洲 CRC 患者的不良预后标志物。建议开展更大规模的验证性研究。
