Intermediate-onset colorectal cancer: a clinical and familial boundary between both early and late-onset colorectal cancer
收藏资源简介：
Comparative studies of colorectal cancer (CRC) according to the age of onset<br> have found differences between early-onset CRC (EOCRC) and late-onset CRC<br> (LOCRC). Using this as a starting point, we wished to determine whether intermediateonset<br> CRC (IOCRC) might also be considered as an independent group within CRC.<br> We performed a retrospective comparative study of the clinicopathological and familial<br> features, as well as of the symptoms and their duration, of a total of 272 subjects<br> diagnosed with CRC classified into three groups according to the age-of-onset (98<br> EOCRC, 83 IOCRC and 91 LOCRC). The results show that from a clinicopathological<br> point of view, IOCRC shared certain features with EOCRC (gender, prognosis), and<br> with LOCRC (multiple primary CRCs), whereas it also had characteristics that were<br> specific for IOCRC (mean number of associated polyps). A gradual progression was<br> observed from EOCRC to LOCRC from a greater family aggregation to sporadic cases,<br> in parallel with a change of Lynch Syndrome cases to the sporadic microsatellite<br> instability pathway, with the IOCRC being a boundary group that is more related to<br> EOCRC. With respect to symptoms, duration and correlation with stages, IOCRC<br> appeared more similar to EOCRC. Clinically, IOCRC behaves as a transitional group<br> between EOCRC and LOCRC, with features in common with both groups, but also<br> with IOCRC-specific features. Excluding cases with familial cancer history, the<br> awareness for EOCRC diagnosis should be extended to IOCRC.
按发病年龄划分的结直肠癌（colorectal cancer, CRC）对比研究均发现，早发性结直肠癌（early-onset CRC, EOCRC）与迟发性结直肠癌（late-onset CRC, LOCRC）之间存在显著差异。 以此为研究起点，我们旨在明确中间发性结直肠癌（intermediate-onset CRC, IOCRC）是否亦可作为结直肠癌中的独立亚型。 本研究针对272例经确诊的结直肠癌患者开展回顾性对比分析，按发病年龄将其划分为三组（98例EOCRC、83例IOCRC及91例LOCRC），并对其临床病理特征、家族特征、症状表现及病程时长进行了系统研究。 研究结果显示，从临床病理维度来看，IOCRC与EOCRC存在部分共通特征（如性别分布、预后情况），与LOCRC亦存在部分共通特征（如多原发结直肠癌），同时还具备IOCRC特有的临床病理特征（如伴发息肉的平均数量）。 从家族聚集性更强的病例逐渐过渡到散发病例的过程中，可观察到从EOCRC到LOCRC的渐变特征；与此同时，林奇综合征（Lynch Syndrome）病例占比逐渐向散发性微卫星不稳定（microsatellite instability）通路转变，而IOCRC作为过渡亚型，与EOCRC的相关性更强。 在症状表现、病程时长及与肿瘤分期的相关性方面，IOCRC与EOCRC更为相似。 临床层面上，IOCRC作为EOCRC与LOCRC之间的过渡亚型，兼具两组的共通特征，同时亦拥有IOCRC专属的临床特征。 排除存在家族性癌症病史的病例后，结直肠癌诊断的筛查意识应从EOCRC拓展至IOCRC范畴。
