Awad Heyam, Elshebli Sanad, Hasan Khaled, Eid Yousef, Obeidat Fatima, Alzyoud Mohammad, Alakhras Basheer, AlShammas Faris
Department of Histopathology, Microbiology and Forensic Medicine, University of Jordan, Amman 11942, Jordan.
Department of Lab Medicine, Jordan University Hospital, Amman 11942, Jordan.
Diagnostics (Basel). 2024 Aug 11;14(16):1743. doi: 10.3390/diagnostics14161743.
The incidence of colorectal carcinoma (CRC) is increasing among individuals younger than 50, and some studies suggest the presence of differences in CRC among old and young individuals regarding clinical and histopathological features. The aim of this study was to compare clinicopathological features, mismatch repair protein status, and expression of certain immunohistochemical stains between young and old groups. The study included 180 cases and found significant histological and immunohistochemical differences between the two groups. CRC in the young tends to be more right-sided and has a higher percentage of dMMR proteins, but less expression of p53 mutations. These features are commoner in Lynch syndrome, and more investigations to study the relationship between young-onset CRC and hereditary syndromes are needed. Young-onset CRC also tends to show higher expression of tumor cell PD-L1, which is an expected finding, as dMMR cases are more likely to be immunogenic. Two other significant differences are the higher percentage of mucinous carcinoma and the higher tumor grade in young-onset CRC. These two features suggest a more advanced disease with possibly worse outcomes; however, there is no difference in disease stage between the two age groups.
在50岁以下人群中，结直肠癌（CRC）的发病率正在上升，一些研究表明，在临床和组织病理学特征方面，老年和年轻个体的结直肠癌存在差异。本研究的目的是比较年轻组和老年组之间的临床病理特征、错配修复蛋白状态以及某些免疫组化染色的表达情况。该研究纳入了180例病例，发现两组之间在组织学和免疫组化方面存在显著差异。年轻患者的结直肠癌往往更偏向右侧，错配修复缺陷（dMMR）蛋白的比例更高，但p53突变的表达较少。这些特征在林奇综合征中更为常见，因此需要更多研究来探讨早发性结直肠癌与遗传综合征之间的关系。早发性结直肠癌还往往表现出肿瘤细胞程序性死亡受体配体1（PD-L1）的高表达，这是一个预期的发现，因为dMMR病例更有可能具有免疫原性。另外两个显著差异是黏液癌的比例更高以及早发性结直肠癌的肿瘤分级更高。这两个特征表明疾病进展更为严重，预后可能更差；然而，两个年龄组之间的疾病分期没有差异。
