Fireman Z, Shabtai F, Lurie B
Gastroenterology Unit, Golda Medical Center (Hasharon Hospital), Petah-Tikva, Israel.
Dis Colon Rectum. 1994 Dec;37(12):1317-20. doi: 10.1007/BF02257804.
The incidence of colorectal cancer in young adults (under 40 years of age) is rare. The reason for the occurrence in these patients may lie in their genetic background.
We studied chromosomal fragility in peripheral blood lymphocytes of patients under the age of 40 with large bowel cancer. Lymphocytes from 24 subjects were examined: 10 untreated large bowel cancer patients under the age of 40 and 14 age-matched and sex-matched controls.
The mean number of spontaneous chromosomal breaks per cells (b/c) was significantly higher in the right-sided large bowel cancer patients (0.23 +/- 0.12 b/c) compared with the control group (0.09 +/- 0.04 b/c; P < 0.01), but with no significant difference between the left-sided colorectal cancer patients and the control group. Lymphocytes exposed to the radiomimetic agent, bleomycin, were arrested in methaphase and analyzed for chromosome fragility. Mean chromosome breaks per cell in the left-sided colorectal cancer patients (1.60 +/- 0.49 b/c) were significantly higher than in either the controls (0.72 +/- 0.31 b/c; P < 0.001) or the right-sided, large bowel cancer patients (0.91 +/- 0.24 b/c; P < 0.05).
The increased spontaneous chromosomal breaks in the right colon, as opposed to the increased mutagen-induced chromosomal breaks in the left colon, might indicate that in young colon cancer patients the occurrence of right-sided colon cancer is more likely to be genetically determined, whereas in left-sided colon cancer, environmental carcinogens might play a greater role.
青年(40岁以下)结直肠癌的发病率较低。这些患者发病的原因可能在于其遗传背景。
我们研究了40岁以下大肠癌患者外周血淋巴细胞的染色体脆性。检测了24名受试者的淋巴细胞:10名未经治疗的40岁以下大肠癌患者以及14名年龄和性别匹配的对照者。
右侧大肠癌患者每细胞自发染色体断裂的平均数(b/c)(0.23±0.12 b/c)显著高于对照组(0.09±0.04 b/c;P<0.01),但左侧结直肠癌患者与对照组之间无显著差异。将淋巴细胞暴露于拟放射性药物博来霉素后,使其停滞在中期并分析染色体脆性。左侧结直肠癌患者每细胞的平均染色体断裂数(1.60±0.49 b/c)显著高于对照组(0.72±0.31 b/c;P<0.001)或右侧大肠癌患者(0.91±0.24 b/c;P<0.05)。
与左侧结肠癌中诱变剂诱导的染色体断裂增加相反,右侧结肠自发染色体断裂增加可能表明,在年轻结肠癌患者中,右侧结肠癌的发生更可能由遗传决定,而在左侧结肠癌中,环境致癌物可能起更大作用。