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早发性结直肠癌:从实验室到临床。

Early-Onset colorectal Cancer: From the laboratory to the clinic.

机构信息

Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, Personalized Medicine, Phamacogenomics and Therapeutic Optimization, Paris, France; Institut du Cancer Paris CARPEM, AP-HP Centre, Department of Gastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou, Paris, France.

Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, Personalized Medicine, Phamacogenomics and Therapeutic Optimization, Paris, France; Institut du Cancer Paris CARPEM, AP-HP Centre, Department of Gastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou, Paris, France.

出版信息

Cancer Treat Rev. 2024 Nov;130:102821. doi: 10.1016/j.ctrv.2024.102821. Epub 2024 Aug 30.

Abstract

Colorectal cancer that occurs before age of 50 is defined as Early-Onset Colorectal Cancer (EOCRC). Its incidence has worryingly increased since the late 90 s and is expected to keep rising in the next future, despite Late-Onset CRC (LOCRC) is decreasing worldwide. Because of this, there is an urgent need to better understand this subset of patients in order to give them the best treatment possible. However, most of the literature is retrospective and often discordant. In this review, we aim to provide a general overview of the issue, endeavoring to highlight the current available knowledge. We decided to move from the beginning, investigating risk factors and inheritance, passing through diagnosis and clinical aspects, and to conclude with the translational part, focusing on the biology of the tumor. However, lot of questions remain open, including screening age and prognosis. Indeed, young patients tend to be treated more aggressively, even if a survival benefit has not been proven yet. Every clinician should be aware of the best practice for young people, and more translational studies are awaited in order to clarify is EOCRC represents a distinct biological entity.

摘要

发生在 50 岁之前的结直肠癌被定义为早发性结直肠癌(EOCRC)。自 90 年代末以来,其发病率令人担忧地增加,预计在未来仍将继续上升,尽管全球迟发性结直肠癌(LOCRC)正在减少。因此,迫切需要更好地了解这部分患者,以便为他们提供最佳治疗。然而,大多数文献都是回顾性的,而且往往存在不一致之处。在这篇综述中,我们旨在提供一个问题的概述,努力突出当前可用的知识。我们决定从一开始,调查风险因素和遗传,通过诊断和临床方面,最后以转化部分结束,重点是肿瘤的生物学。然而,许多问题仍然存在,包括筛查年龄和预后。事实上,年轻患者的治疗往往更加积极,即使尚未证明生存获益。每个临床医生都应该了解针对年轻人的最佳治疗方法,并且期待更多的转化研究来阐明 EOCRC 是否代表一种独特的生物学实体。

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