Clinicopathologic and genetic features of young patients with colorectal cancer
نویسندگان
چکیده
Results 441 individuals from 353 families were identified, and to-date, medical records confirmed 254 diagnoses, which were included for analysis. Ninety patients (35.4%) had germline mutations in self or kin (31 MSH2, 36 MLHI, 1 MSH6, 3 PMS2, 24 APC, 2 MYH biallelic and 1 BRCA2). Individuals were classified into six categories; (a) 74 had Lynch syndrome (LS) confirmed by germline mutation or tumour deficiency (b) 4 had constitutional mismatch repair-deficiency (CMMR-D) (c) 61 had polyposis (mutation positive, >25 adenomas or hamartomatous polyps), (d) 6 met Family X criteria, (e) 7 had inflammatory bowel disease (IBD), and (f) 102 were unclassified (NOS), with 69 of these individuals having MSS and/or IHC intact tumours. On average, patients with CMMR-D presented younger, with a mean age of 14 years old at diagnosis. 65.2% of patients with LS presented with a proximal tumour (65.2%) compared with the polyposis (10.2%) and NOS (34.4%) groups. In contrast, 83% of polyposis patients and 65.5% of NOS patients presented with distal colon or rectal cancers. Family history was significant for the majority of LS patients with 54 of 73 (74%) meeting Amsterdam I or II criteria. Two of the 7 patients with IBD, and 15 of 98 NOS patients also met Amsterdam I/II criteria, as opposed to the CMMR-D families where none met these criteria. Six LS patients presented with sporadic CRC, as did approximately 25% of polyposis patients and 59.2% of the NOS patients.
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