Isah Tsamiya Rilwanu, Mohd Nafi Siti Norasikin, Che Jalil Nur Asyilla, Mat Zin Anani Aila
Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Hospital Universiti Sains Malaysia, Kelantan, Malaysia.
Malays J Med Sci. 2024 Feb;31(1):200-211. doi: 10.21315/mjms2024.31.1.17. Epub 2024 Feb 28.
The prevalence of colorectal cancer (CRC) among young individuals is rising worldwide, especially in Malaysia. Investigations are currently employed to distinguish the features of young-onset CRC (YOCRC) from adult-onset CRC (AOCRC). This study aimed to compare the characteristics of patients with YOCRC and AOCRC diagnosed at Hospital Universiti Sains Malaysia (HUSM).
This was a retrospective study of CRC cases from January 2013 to December 2021. The details of YOCRC (< 50 years old) and AOCRC (≥ 50 years old) patients were retrieved from the laboratory system and medical records. The Pearson's chi-square test, Fisher's exact test and multiple logistic regression were used to compare the AOCRC and YOCRC cases. Statistical significance was defined at a value of ≤ 0.05.
The AOCRC (254/319, 79.6%) was more prevalent than YOCRC (65/319, 20.4%), with a predominance of males (53.9%) and Malay sub-population (90.2%). AOCRC and YOCRC shared similarities in left-sided location, high occurrence of adenocarcinoma with moderately differentiated histology and advanced stage of diagnosis. More patients with YOCRC (23.1%) had a family history of cancer than patients with AOCRC. YOCRC also differed from AOCRC by having more specific histological subtypes, such as mucinous adenocarcinoma (15.4%) and signet ring carcinoma (6.2%). In addition, patients with YOCRC commonly presented with a low density of tumour-infiltrating lymphocytes (TILs) (60%). Multiple logistic regression showed a family history of CRC (adjusted odds ratio [AOR] = 3.75, = 0.003) and histological type (AOR = 15.21, < 0.001) are more likely to cause YOCRC than diabetes (AOR = 0.06, < 0.001) and hypertension (AOR = 0.14, < 0.001) comorbidities, which are associated with AOCRC.
Our descriptive study presented the epidemiological and histopathological characteristics of AOCRC and YOCRC in HUSM, providing current information on distinguishing features between the groups.
全球范围内，尤其是在马来西亚，年轻个体中结直肠癌（CRC）的患病率正在上升。目前正在进行调查，以区分青年发病型结直肠癌（YOCRC）和成年发病型结直肠癌（AOCRC）的特征。本研究旨在比较在马来西亚理科大学医院（HUSM）诊断的YOCRC和AOCRC患者的特征。
这是一项对2013年1月至2021年12月期间CRC病例的回顾性研究。从实验室系统和病历中检索YOCRC（<50岁）和AOCRC（≥50岁）患者的详细信息。采用Pearson卡方检验、Fisher精确检验和多元逻辑回归对AOCRC和YOCRC病例进行比较。统计学显著性定义为≤0.05。
AOCRC（254/319，79.6%）比YOCRC（65/319，20.4%）更常见，以男性（53.9%）和马来亚人群（90.2%）为主。AOCRC和YOCRC在左侧位置、高分化腺癌组织学发生率高和诊断分期晚方面具有相似性。与AOCRC患者相比，更多的YOCRC患者（23.1%）有癌症家族史。YOCRC与AOCRC的不同之处还在于有更多特定的组织学亚型，如黏液腺癌（15.4%）和印戒癌（6.2%）。此外，YOCRC患者通常肿瘤浸润淋巴细胞（TILs）密度较低（60%）。多元逻辑回归显示，CRC家族史（调整比值比[AOR]=3.75，P=0.003）和组织学类型（AOR=15.21，P<0.001）比与AOCRC相关的糖尿病（AOR=0.06，P<0.001）和高血压（AOR=0.14，P<0.001）合并症更易导致YOCRC。
我们的描述性研究展示了HUSM中AOCRC和YOCRC的流行病学和组织病理学特征，提供了关于两组之间鉴别特征的当前信息。
