Clinicopathologic Features Analysis of Patients with Hereditary Nonpolyposis Colorectal Cancer in Northeast Chinese_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YAN Yifei ,  LI Xiaoxia , TANG Yuanxin , LI Xin , SUN Gongping , ZHAO Meng , MENG Jin , LIANG Gaofeng

Department of Gastrointestinal Surgery， The Fourth Affiliated Hospital， China Medical University， Shenyang 110032， Liaoning Province， China;

Corresponding author：

LI Xiaoxia, Email: lxx555999@yahoo.com.cn

Keywords：

Hereditary nonpolyposis colorectal cancer; Clinicopathologic feature

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Objective 　To analyze the clinical pathological features of patients with hereditary nonpolyposis colorectal cancer （HNPCC） in northeast Chinese.
Methods 　The clinical data of 101 probands （HNPCC group） from 1982 to 2011 in the Fourth Affiliated Hospital of China Medical University and Tumor hospital of Liaoning Province and 272 patients with sporadic colorectal cancer （sporadic CRC group） in the same period were collected. The clinicopathologic features were compared in two groups.
Results 　In the HNPCC group， the age of onset was younger than 45 years old in 24 patients （23.8%）， proximal colon in 31 （30.7%）， multiple primary carcinomas in 26 （25.7%）， extracolonic carcinoma in 13 （12.9%）， mucinous adenocarcinoma in 32 （31.7%）， phaseⅠandⅡin 68 （67.3%）， high-middle differentiation in 70 （69.3%）， and lymph node metastasis in 33 （32.7%）， while in the sporadic CRC group were 12 （4.4%）， 54 （19.9%）， 15 （5.5%）， 11 （4.0%）， 30 （11.0%）， 127 （46.7%）， 152 （55.9%）， and 140 （51.5%）， respectively. There were significant differences between the HNPCC group and the sporadic CRC group （P＜0.05）. Meanwhile， extracolonic carcinomas in the HNPCC group were endometrial cancer in 3， bladder cancer in 3， breast cancer in 2， brain tumor in 2， ovarian cancer in 1， gastric cancer in 1， and lung cancer in 1.
Conclusions 　Northeast China HNPCC patients with several particular clinicopathologic features such as early onset， frequent localization in proximal colon， proclivity of synchronous and metachronous tumors， excessive mucinous adenocarcinoma， less poorly differentiated tumors， lymph node metastasis， early stage of tumor， and so on. Therefore， clinicopathologic feature is still a preferred method of diagnosis of HNPCC patients or suspected HNPCC patients.

Citation： YAN Yifei,LI Xiaoxia,TANG Yuanxin,LI Xin,SUN Gongping,ZHAO Meng,MENG Jin,LIANG Gaofeng,.. Clinicopathologic Features Analysis of Patients with Hereditary Nonpolyposis Colorectal Cancer in Northeast Chinese. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(2): 138-142. doi: Copy

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2.	Aaltonen LA， Peltomäki P， Mecklin JP， et al. Replication errorsin benign and malignant tumors from hereditary nonpolyposis colorectal cancer patients[J]. Cancer Res， 1994， 54(7)：1645-1648.
3.	Peltomäki P， Lothe RA， Aaltonen LA， et al. Microsatellite insta-bility is associated with tumors that characterize the hereditary non-polyposis colorectal carcinoma syndrome[J]. Cancer Res， 1993， 53(24)：5853-5855.
4.	Fishel R， Lescoe MK， Rao MR， et al. The human mutator gene homolog MSH2 and its association with hereditary nonpolyposis colon cancer[J]. Cell， 1993， 75(5)：1027-1038.
5.	Vasen HF， Mecklin JP， Khan PM， et al. The International Colla-borative Group on hereditary non-polyposis colorectal cancer (ICG-HNPCC)[J]. Dis Colon Rectum， 1991， 34(5)：424-425.
6.	Vasen HF， Watson P， Mecklin JP， et al. New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC， Lynch syndrome) proposed by the International Collaborative group on HNPCC[J]. Gastroenterology， 1999， 116(6)：1453-1456.
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13.	丁元升，商嵩山，张剑权，等. 新疆地区遗传性非息肉病性大肠癌临床病理特点分析[J]. 山东医药， 2010， 50(34)：10-11.
14.	Kalady MF， Lipman J， McGannon E， et al. Risk of colonic neoplasia after proctectomy for rectal cancer in hereditary nonpolyposis colorectal cancer[J]. Ann Surg， 2012， 255(6)：1121-1125.
15.	Watson P， Vasen HF， Mecklin JP， et al. The risk of extra-colonic，extra-endometrial cancer in the Lynch syndrome[J]. Int J Cancer，.
16.	Yuan Y， Ye J， Zheng S， et al. Clinical and genetic features of International collaborative Group-hereditary nonpolyposis colorectal cancer families and suspected hereditary nonpolyposis colorectal cancer families[J]. Chin Med J， 2004， 117(5)：748-752.
17.	李晓霞，唐元新，孙公平，等. 中国东北地区遗传性非息肉病性结直肠癌家系肠外肿瘤谱特点分析[J]. 中国普外基础与临床杂志， 2012， 19(3)：288-291.
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19.	吴菲，林国桢，张晋昕，等. 我国恶性肿瘤发病现状及趋势[J]. 中国肿瘤， 2012， 21(4)：81-85.
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21.	Drescher KM， Sharma P， Watson P， et al. Lymphocyte recruitment into the tumor site is altered in patients with MSI-H colon cancer[J]. Fam Cancer， 2009， 8(3)：231-239.
22.	Dolcetti R， Viel A， Doglioni C， et al. High prevalence of activated intraepithelial cytotoxic T lymphocytes and increased neoplastic cell apoptosis in colorectal carcinomas with microsatellite instability[J]. Am J Pathol， 1999， 154(6)：1805-1813.
23.	Herráiz M， Muñoz-Navas M. Recognition and management of hereditary colorectal cancer syndromes[J]. Rev Esp Enferm Dig， 2009， 101(2)：125-132.
24.	Koornstra JJ， Mourits MJ， Sijmons RH， et al. Management of extracolonic tumours in patients with Lynch syndrome[J]. LancetOncol， 2009， 10(4)：400-408.
25.	Haanstra JF， de Vos Tot Nederveen Cappel WH， Gopie JP， et al.Quality of life after surgery for colon cancer in patients with Lynch syndrome：partial versus subtotal colectomy[J]. Dis ColonRectum， 2012， 55(6)：653-659.
26.	de Vos tot Nederveen Cappel WH， Nagengast FM， Griffioen G， et al. Surveillance for hereditary nonpolyposis colorectal cancer：a long-term study on 114 families[J]. Dis Colon Rectum， 2002， 45(12)：1588-1594.
27.	， 123(2)：444-449.
28.	， 5(3)：385-399.

1. Lynch HT， de la Chapelle A. Hereditary colorectal cancer[J]. N Engl J Med， 2003， 348(10)：919-932.
2. Aaltonen LA， Peltomäki P， Mecklin JP， et al. Replication errorsin benign and malignant tumors from hereditary nonpolyposis colorectal cancer patients[J]. Cancer Res， 1994， 54(7)：1645-1648.
3. Peltomäki P， Lothe RA， Aaltonen LA， et al. Microsatellite insta-bility is associated with tumors that characterize the hereditary non-polyposis colorectal carcinoma syndrome[J]. Cancer Res， 1993， 53(24)：5853-5855.
4. Fishel R， Lescoe MK， Rao MR， et al. The human mutator gene homolog MSH2 and its association with hereditary nonpolyposis colon cancer[J]. Cell， 1993， 75(5)：1027-1038.
5. Vasen HF， Mecklin JP， Khan PM， et al. The International Colla-borative Group on hereditary non-polyposis colorectal cancer (ICG-HNPCC)[J]. Dis Colon Rectum， 1991， 34(5)：424-425.
6. Vasen HF， Watson P， Mecklin JP， et al. New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC， Lynch syndrome) proposed by the International Collaborative group on HNPCC[J]. Gastroenterology， 1999， 116(6)：1453-1456.
7. Umar A， Boland CR， Terdiman JP， et al. Revised Bethesda Guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability[J]. J Natl Cancer Inst， 2004， 96(4)：261-268.
8. Lynch HT， Lynch PM， Lanspa SJ， et al. Review of the lynch syndrome：history， molecular genetics， screening， differential diagnosis， and medicolegal ramifications[J]. Clin Genet， 2009， 76(1)：1-18.
9. Pino MS， Chung DC. Microsatellite instability in the management of colorectal cancer[J]. Expert Rev Gastroenterol Hepatol，.
10. 李建胜，俞美萍，莫善兢，等. 遗传性非息肉病性大肠癌18个家系64例分析[J]. 中国中西医结合外科杂志， 2010， 16(6)：619-623.
11. Lynch HT， Smyrk T. Hereditary nonpolyposis colorectal cancer (Lynch syndrome). An updated review[J]. Cancer， 1996， 78(6)：1149-1167.
12. Drescher KM， Sharma P， Lynch HT. Current hypotheses on how microsatellite instability leads to enhanced survival of Lynch syndrome patients[J]. Clin Dev Immunol， 2010， 2010：170432.
13. 丁元升，商嵩山，张剑权，等. 新疆地区遗传性非息肉病性大肠癌临床病理特点分析[J]. 山东医药， 2010， 50(34)：10-11.
14. Kalady MF， Lipman J， McGannon E， et al. Risk of colonic neoplasia after proctectomy for rectal cancer in hereditary nonpolyposis colorectal cancer[J]. Ann Surg， 2012， 255(6)：1121-1125.
15. Watson P， Vasen HF， Mecklin JP， et al. The risk of extra-colonic，extra-endometrial cancer in the Lynch syndrome[J]. Int J Cancer，.
16. Yuan Y， Ye J， Zheng S， et al. Clinical and genetic features of International collaborative Group-hereditary nonpolyposis colorectal cancer families and suspected hereditary nonpolyposis colorectal cancer families[J]. Chin Med J， 2004， 117(5)：748-752.
17. 李晓霞，唐元新，孙公平，等. 中国东北地区遗传性非息肉病性结直肠癌家系肠外肿瘤谱特点分析[J]. 中国普外基础与临床杂志， 2012， 19(3)：288-291.
18. 徐肇翊， Brown L，潘国伟，等. 中国北方城市肺癌与生活方式及环境污染的关系[J]. 肿瘤， 1996， 16(4)：506-508.
19. 吴菲，林国桢，张晋昕，等. 我国恶性肿瘤发病现状及趋势[J]. 中国肿瘤， 2012， 21(4)：81-85.
20. Buckowitz A， Knaebel HP， Benner A， et al. Microsatellite insta-bility in colorectal cancer is associated with local lymphocyte infilt-ration and low frequency of distant metastases[J]. Br J Cancer， 2005， 92(9)：1746-1753.
21. Drescher KM， Sharma P， Watson P， et al. Lymphocyte recruitment into the tumor site is altered in patients with MSI-H colon cancer[J]. Fam Cancer， 2009， 8(3)：231-239.
22. Dolcetti R， Viel A， Doglioni C， et al. High prevalence of activated intraepithelial cytotoxic T lymphocytes and increased neoplastic cell apoptosis in colorectal carcinomas with microsatellite instability[J]. Am J Pathol， 1999， 154(6)：1805-1813.
23. Herráiz M， Muñoz-Navas M. Recognition and management of hereditary colorectal cancer syndromes[J]. Rev Esp Enferm Dig， 2009， 101(2)：125-132.
24. Koornstra JJ， Mourits MJ， Sijmons RH， et al. Management of extracolonic tumours in patients with Lynch syndrome[J]. LancetOncol， 2009， 10(4)：400-408.
25. Haanstra JF， de Vos Tot Nederveen Cappel WH， Gopie JP， et al.Quality of life after surgery for colon cancer in patients with Lynch syndrome：partial versus subtotal colectomy[J]. Dis ColonRectum， 2012， 55(6)：653-659.
26. de Vos tot Nederveen Cappel WH， Nagengast FM， Griffioen G， et al. Surveillance for hereditary nonpolyposis colorectal cancer：a long-term study on 114 families[J]. Dis Colon Rectum， 2002， 45(12)：1588-1594.
27. ， 123(2)：444-449.
28. ， 5(3)：385-399.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinicopathologic Features Analysis of Patients with Hereditary Nonpolyposis Colorectal Cancer in Northeast Chinese

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