Association of Polyps with Early-Onset Colorectal Cancer and Throughout Surveillance: Novel Clinical and Molecular Implications
Abstract
:1. Introduction
2. Results
2.1. Overall Features
2.2. Comparative Analysis of EOCRC with and without Associated Polyps
2.2.1. Clinicopathological and Familial Differences
2.2.2. Molecular Differences
2.3. Comparative Analysis of Patients with EOCRC with the Development of Polyps during the Subsequent Follow-Up
3. Discussion
4. Materials and Methods
4.1. Families, Samples and Data Collection
4.2. Analysis of Microsatellite Instability (MSI) and Mutations in Mismatch Repair (MMR) Genes
4.3. Other Molecular Analyses
4.3.1. Mutational Status Analysis by Next Generation Sequencing
4.3.2. Chromosomal Instability
4.3.3. CpG Island Methylator Phenotype
4.4. Statistical Analyses
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Global n (%) | No polyps n (%) | Polyps n (%) | p (χ2) | |
---|---|---|---|---|
Patients | 119 (100) | 56 (47) | 63 (53) | − |
Mean age of onset (±SD) 1 (years) | 40.7 (±4.4) | 41.0 (±4.4) | 40.6 (±4.1) | NS |
Sex: | ||||
Male | 67 (56) | 37 (55) | 30 (45) | NS |
Female | 52 (44) | 26 (50) | 26 (50) | |
Colon location: | 0.064 | |||
Right | 29 (25) | 9 (16) | 20 (32) | |
Left | 42 (35) | 19 (34) | 23 (36) | |
Rectum | 48 (40) | 28 (50) | 20 (32) | |
Mucin production 2 | 21/79 (26) | 16/48 (33) | 5/31 (16) | NS |
“Signet ring” cells 2 | 3/98 (3) | 2/51 (4) | 1/47 (2) | NS |
Stage at diagnosis: | <0.001 | |||
I | 47 (39) | 9 (16) | 38 (60) | |
II | 25 (21) | 9 (16) | 16 (25) | |
III | 18 (15) | 14 (25) | 4 (6) | |
IV | 29 (24) | 24 (43) | 5 (8) | |
Overall survival (±SD) 1 (months) | 76.7 (±45.6) | 58.8 (±47.1) | 94.5 (±36.6) | 0.012 |
Disease-free survival (±SD) 1 (months) | 68.1(±51.9) | 45.3 (±52.2) | 90.6 (±40.7) | <0.001 |
Synchronous CRCs | 5/119 (4) | 1/56 (2) | 4/63 (6) | NS |
Family history of cancer | ||||
Aggregation for Lynch-related neoplasm | 56 (48) | 20 (37) | 36 (58) | 0.027 |
Aggregation for CRC | 43 (37) | 13 (24) | 30 (48) | 0.007 |
Aggregation for Lynch-unrelated neoplasm | 10 (13) | 13 (24) | 23 (37) | NS |
Sporadic cases | 33 (41) | 30 (54) | 16 (26) | 0.002 |
Chr | Start | End | Region | Region | Size (Mb) | P Group % Gains | % Losses | NP Group % Gains | % Losses |
---|---|---|---|---|---|---|---|---|---|
chr 1 | 49547237 | 50769506 | p33 | p32.3 | 1,222269 | 5,263157895 | 47,36842105 | 4,761904762 | 14,28571429 |
chr 1 | 50819987 | 52195285 | p32.3 | p32.3 | 1,375298 | 26,31578947 | 26,31578947 | 23,80952381 | 0 |
chr 1 | 204672629 | 208121292 | q32.1 | q32.2 | 3,448663 | 0 | 21,05263158 | 9,523809524 | 0 |
chr 3 | 38942563 | 46420768 | p22.2 | p21.31 | 7,478205 | 5,263157895 | 31,57894737 | 19,04761905 | 5,263157895 |
chr 5 | 14473935 | 16465030 | p15.2 | p15.1 | 1,991095 | 15,78947368 | 21,05263158 | 14,28571429 | 0 |
chr 5 | 20785106 | 21941459 | p14.3 | p14.3 | 1,156353 | 5,263157895 | 47,36842105 | 14,28571429 | 14,28571429 |
No Polyps During Follow-Up (NPDF) n (%) | Polyp Development During Follow-Up (PDFU) n (%) | Polyp Development after 5 Years of Follow-Up (P > 5FU) n (%) | Polyp Development before 5 Years of Follow-Up (P < 5FU) n (%) | p (χ2) | |
---|---|---|---|---|---|
Patients | 37 | 17 | 7 | 32 | − |
Mean age of onset (±SD) 1 (years) | 40.8 (±4.4) | 39.2 (±4.4) | 40.4 (±5) | 41.5 (±3.6) | NS |
Sex: | |||||
Male | 20 (54) | 8 (47) | 5 (71) | 21 (66) | |
Female | 17 (46) | 9 (53) | 2 (29) | 11 (34) | NS |
Colon location: | NS | ||||
Right | 7 (19) | 9 (53) | 2 (29) | 8 (25) | |
Left | 13 (35) | 3 (18) | 4 (57) | 13 (41) | |
Rectum | 17 (46) | 5 (29) | 1 (14) | 11 (34) | |
Type of surgery: | |||||
Curative | 30 (81) | 17 (100) | 7 (100) | 31 (97) | 0.037 |
Palliative | 7 (19) | 0 (0) | 0 (0) | 1 (3) | |
Mucin production 2 | 9/29 (31) | 3/8 (38) | 3/6 (50) | 0/14 (0) | 0.055 |
“Signet ring” cells | 2/31 (7) | 0/11 (0) | 0/7 (0) | 1/26 (4) | NS |
Stage at diagnosis: | |||||
I | 12 (33) | 10 (59) | 2 (28) | 21 (65) | |
II | 6 (16) | 4 (24) | 5 (71) | 8 (25) | |
III | 10 (27) | 2 (12) | 0 (0) | 2 (6) | 0.003 |
IV | 9 (24) | 1 (6) | 0 (0) | 1 (3) | |
Overall survival (±SD) 1 (months) | 84 (±45) | 114 (±25) | 88 (±21) | 88 (±34) | 0.04 |
Disease-free survival (±SD) 1 (months) | 74 (±51) | 114 (±25) | 88 (±21) | 81 (±38) | 0.012 |
Synchronous CRCs | 1 (3) | 2 (12) | 0 (0) | 1 (3) | NS |
Family history of cancer | |||||
Aggregation for Lynch-related neoplasm | 16/37 (43) | 12/17 (71) | 4/7 (57) | 16/32 (50) | NS |
Aggregation for CRC neoplasm | 12/37 (32) | 12/17 (71) | 3/7 (43) | 12/32 (38) | 0.032 |
Aggregation for Lynch-unrelated neoplasm | 11/37 (30) | 8/17 (47) | 3/7 (32) | 7/32 (22) | NS |
Sporadic cases | 18/37 (49) | 2/17 (12) | 2/7 (29) | 11/32 (34) | 0.069 |
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Perea García, J.; Arribas, J.; Cañete, Á.; García, J.L.; Álvaro, E.; Tapial, S.; Narváez, C.; Vivas, A.; Brandáriz, L.; Hernández-Villafranca, S.; et al. Association of Polyps with Early-Onset Colorectal Cancer and Throughout Surveillance: Novel Clinical and Molecular Implications. Cancers 2019, 11, 1900. https://doi.org/10.3390/cancers11121900
Perea García J, Arribas J, Cañete Á, García JL, Álvaro E, Tapial S, Narváez C, Vivas A, Brandáriz L, Hernández-Villafranca S, et al. Association of Polyps with Early-Onset Colorectal Cancer and Throughout Surveillance: Novel Clinical and Molecular Implications. Cancers. 2019; 11(12):1900. https://doi.org/10.3390/cancers11121900
Chicago/Turabian StylePerea García, José, Julia Arribas, Ángel Cañete, Juan Luis García, Edurne Álvaro, Sandra Tapial, Cristina Narváez, Alfredo Vivas, Lorena Brandáriz, Sergio Hernández-Villafranca, and et al. 2019. "Association of Polyps with Early-Onset Colorectal Cancer and Throughout Surveillance: Novel Clinical and Molecular Implications" Cancers 11, no. 12: 1900. https://doi.org/10.3390/cancers11121900