Do Young Patients with Colorectal Cancer Have a Poorer Prognosis than Old Patients?
Do Young Patients with Colorectal Cancer Have a Poorer Prognosis than Old Patients?
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DOI：
10.1016/j.jss.2010.10.040
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发表时间：
2011-05-01
影响因子：
2.2
通讯作者：
Gu, Jin
中科院分区：
文献类型：
--
作者：
Li, Ming;Li, Ji-You;Gu, Jin
背景资料。结直肠癌(CRC)通常是一种老年疾病。与老年患者相比，年轻人的结直肠癌的预后和临床病理特征仍有争议。本研究的目的是比较40岁以下和40岁以上的结直肠癌患者的生存率、临床病理特征和肿瘤标志物。共对230例I-III期大肠癌患者进行了回顾性评估，以根治手术后复发或转移为终点。采用免疫组织化学方法检测癌胚抗原、基质金属蛋白酶-2和p27(Kip1)的表达。青年组28例(12.2%)年龄在40岁或以下，中位年龄36岁。老年组202例(87.8%)，中位年龄61岁。青年组与老年组在性别分布、肿瘤部位、肿瘤大小、大体类型等方面无统计学差异。青年组粘液腺癌发生率(17.9%)高于老年组(6.4%)(P=0.035)。不同分期、分化程度及静脉侵犯程度分布相似。中位无病生存时间青年组为60mo，老年组为49mo。单因素分析显示，这一差异无统计学意义(P=0.1158)。多因素COX回归分析也表明，患者年龄不是影响结直肠癌预后的独立因素。青年组与老年组CEA、MMP2、p27(Kip1)的表达差异无统计学意义。这项研究的结果表明，青年和老年结直肠癌患者粘液腺癌的发生率存在细微差异。然而，I-III期年轻患者的无病生存期与老年患者相似。青年和老年结直肠癌患者的其他临床病理特征和肿瘤标志物如CEA、MMP2和p27(Kip1)也相似。(C)2011 Elsevier Inc.保留所有权利。
Background. Colorectal cancer (CRC) is generally a disease of the older population. The prognosis and clinicopathologic features of CRC in the young, compared with those in older patients, continue to be debated. The aim of this study was to compare the survival, clinicopathologic features, and tumor markers of CRC in patients aged 40 y or younger and older patients.Methods. A total of 230 patientswithCRCof stage I-III were assessed retrospectively, with an endpoint of recurrence or metastasis after curative operation. The markersCEA, MMP-2, and p27(kip1) were studied by immunohistochemistry in all patients.Results. The young group comprised 28 (12.2%) patients aged 40 y or younger with a median age of 36 y. The remaining 202 patients (87.8%) comprised the old group, with a median age of 61 y. There were no statistical differences in gender distribution, tumor sites, tumor size, or gross type between the young and old groups. The young group had a higher incidence of mucinous adenocarcinoma (17.9%) than the old group (6.4%) (P = 0.035). The distribution of stage, differentiation grade, and extent of venous invasion were similar. The median disease-free survival time was 60 mo for the young group and 49 mo for the old. Univariate analysis revealed that this difference was not significant (P = 0.1158). Multivariate Cox regression analysis also demonstrated that the age of the patient was not an independent factor for the prognosis of CRC. There were no statistical differences between the young and old groups in the expression of CEA, MMP-2, or p27(kip1).Conclusions. The results of this study indicated that there was a subtle difference in the incidence of mucinous adenocarcinoma between young and old patients with CRC. However, stage I-III young patients had a similar disease-free survival period as the older patients. Other clinicopathologic characteristics, and tumor markers such as CEA, MMP-2, and p27(kip1), were also similar between young and old CRC patients. (C) 2011 Elsevier Inc. All rights reserved.