Chen Zongyao, Ye Linhan, Liu Yuhang, Geng Menghang, Deng Shuangya, Chen Weidong
Department of Surgery, TUM University Hospital, Klinikum Rechts Der Isar, Munich, Germany.
Department of General Surgery, Central Hospital of Shaoyang, Shaoyang, Hunan Province, People's Republic of China.
Eur J Med Res. 2025 Aug 2;30(1):696. doi: 10.1186/s40001-025-02819-6.
Early-onset CRC is typically defined as CRC diagnosed in individuals under the age of 50 years. The global incidence and mortality rates of early-onset CRC have gradually increased. The clinicopathological features and pathogenesis of early-onset CRC have still not been fully elucidated, and related data are lacking in China. This research aimed to examine the demographic and clinicopathological characteristics of early-onset CRC patients in China.
This retrospective study included all patients newly diagnosed with CRC between 2019 and 2021 in the General Surgery Department of the Second Xiangya Hospital, Central South University.
A total of 1206 CRC cases were included. Among them, 180 cases (14.9%) were early-onset CRC, and 1026 cases were late-onset CRC, all of which were collected and analyzed. Early-onset CRC patients had significantly longer median symptom durations (90 vs. 60 days, P < 0.001). Patients with late-onset CRC less commonly had a family history than patients with early-onset CRC did (25.60% vs. 17.93%, P = 0.022). There was no direct relationship between symptom duration and disease stage at presentation in early-onset CRC patients (P = 0.750). Early-onset CRC patients were more likely to present with advanced disease (stage IV) compared to late-onset CRC patients (24.44% vs. 13.45%, P < 0.001). Additionally, early-onset CRC patients were more likely to present with poorly differentiated tumors (29.81% vs. 12.70%, P < 0.001) and with mucinous or signet-ring cell histology (22.40% vs. 14.17%, P = 0.011) compared to late-onset CRC patients. Deficient mismatch repair (dMMR) tumors were more common in early-onset CRC patients (15.90% vs. 6.28%, P < 0.001). Among early-onset CRC patients, no significant differences were observed in age, sex, BMI, or tumor pathology between those with right-sided and left-sided tumors.
Early-onset CRC has different epidemiology, pathology, and molecular features than late-onset CRC in China. More research is needed to better understand the pathophysiology of early-onset CRC and why there are different characteristics between the two types of CRC.
早发性结直肠癌通常定义为在50岁以下个体中诊断出的结直肠癌。全球早发性结直肠癌的发病率和死亡率逐渐上升。早发性结直肠癌的临床病理特征和发病机制仍未完全阐明，且中国缺乏相关数据。本研究旨在探讨中国早发性结直肠癌患者的人口统计学和临床病理特征。
本回顾性研究纳入了中南大学湘雅二医院普通外科2019年至2021年间新诊断为结直肠癌的所有患者。
共纳入1206例结直肠癌病例。其中，180例（14.9%）为早发性结直肠癌，1026例为晚发性结直肠癌，所有病例均进行了收集和分析。早发性结直肠癌患者的中位症状持续时间显著更长（90天对60天，P<0.001）。晚发性结直肠癌患者有家族史的比例低于早发性结直肠癌患者（25.60%对17.93%，P=0.022）。早发性结直肠癌患者的症状持续时间与就诊时的疾病分期之间无直接关系（P=0.750）。与晚发性结直肠癌患者相比，早发性结直肠癌患者更易出现晚期疾病（IV期）（24.44%对13.45%，P<0.001）。此外，与晚发性结直肠癌患者相比，早发性结直肠癌患者更易出现低分化肿瘤（29.81%对12.70%，P<0.001）以及黏液性或印戒细胞组织学类型（22.40%对14.17%，P=0.011）。错配修复缺陷（dMMR）肿瘤在早发性结直肠癌患者中更为常见（15.90%对6.28%，P<0.001）。在早发性结直肠癌患者中，右侧肿瘤和左侧肿瘤患者在年龄、性别、BMI或肿瘤病理方面未观察到显著差异。
在中国，早发性结直肠癌与晚发性结直肠癌在流行病学、病理学和分子特征方面存在差异。需要更多研究来更好地了解早发性结直肠癌的病理生理学以及两种类型结直肠癌存在不同特征的原因。
