Relationship between age and preoperative tumor-related characteristics in patients with colorectal cancer: a real-world study based on DACCA_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GONG Jiaqi ^1,2 , LIU Ying ^1,2 , ZENG Yu ^1,2 , ZHAN Wenyi ^1,2 ,  WANG Xiaodong ¹ , LI Li ¹

1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Medicine in Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

WANG Xiaodong, Email: wangxiaodong@wchscu.cn

Keywords：

Colorectal cancer; tumor features; database; age

DOI：

10.7507/1007-9424.202201050

Video：

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Objective To analyze the relationship between age and tumor characteristics of colorectal patients served by West China Hospital of Sichuan University as a regional center in the current version of Database from Colorectal Cancer (DACCA). Methods The data of DACCA was updated on January 5, 2022. All data items included age, precancerous lesions, family history of cancer, tumor site, distance of tumor from dentate line, tumor morphology, location, pathological properties of tumor, differentiation, and preoperative TNM stage. The patients were divided into three groups according to the age segment proposed by the United Nations World Health Organization (WHO): 35 years old and below (including infant, infant, child, teenager and youth, young group), 35 to 59 years old (middle-aged group), and 60 years old and above (elderly group). Results After scanning, 7 856 data rows were analyzed. ① There was significant difference in the composition ratio of precancerous lesions with or without among different age groups (χ²=6.219, P=0.045), and the constituent ratio of various precancerous lesions in different age groups was also statistically significant (χ²=51.698, P<0.001). ② There was significant difference in the composition ratio of family history of cancer with or without among different age groups (χ²=50.212, P<0.001), and there was significant difference in the composition ratio of different tumor history among different age groups (χ²=9.880, P=0.027), and there was significant difference in the constituent ratio of various tumor history among relatives in different age groups (χ²=16.138, P=0.003). ③ There were significant differences in the number of primary cancers among different age groups (χ²=12.973, P=0.036). In all patients with single primary rectal cancer, the constituent ratio of different rectal tumor sites among different age groups was statistically significant (χ²=43.817, P<0.001), and in all patients with single primary colon cancer, there was significant difference in the composition ratio of different colon tumor sites between different age groups (χ²=86.704, P<0.001). ④ The distance of tumor from dentate line was statistically significant in different age groups (H=28.589, P<0.001). ⑤ There was no significant difference in the composition ratio of tumor location among different age groups (χ²=14.795, P=0.140). ⑥ There was significant difference in the composition ratio of pathological properties of tumor among different age groups (χ²=121.387, P<0.001). ⑦ The proportion of tumor morphology was significantly different among different age groups (χ²=89.719, P<0.001). ⑧ There were significant differences in differentiation degree of tumor among different age groups (H=43.544, P<0.001). ⑨ There was statistically significant difference in preoperative TNM stage of colorectal cancer among different age groups (H=7.547, P=0.023). Conclusions Preoperative tumor characteristics of colorectal cancer patients are associated with age at diagnosis. Most young colorectal cancer patients do not have precancerous lesions, and once precancerous lesions are present, familial adenomatous polyposis is more common. Younger patients with colorectal cancer also have a higher percentage of relatives with a family history of cancer with colorectal cancer. From the perspective of tumor location, the proportion of single primary cancer in young colorectal cancer is higher than that in middle-aged and elderly patients. Younger patients with rectal cancer have a lower distance of tumor from dentate line, a higher proportion of low differentiated malignant tumors, and a relatively later neoplasm staging.

Citation： GONG Jiaqi, LIU Ying, ZENG Yu, ZHAN Wenyi, WANG Xiaodong, LI Li. Relationship between age and preoperative tumor-related characteristics in patients with colorectal cancer: a real-world study based on DACCA. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(3): 362-370. doi: 10.7507/1007-9424.202201050 Copy

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2.	Fang C, Yang L, Yu Y, et al. Rectal cancer in West China: younger onset, poor survival, and poor compliance. Dis Colon Rectum, 2021, 64(6): 639-641.
3.	Patel SG, Murphy CC, Lieu CH, et al. Early age onset colorectal cancer. Adv Cancer Res, 2021, 151: 1-37.
4.	陳萬青, 李霓, 蘭平, 等. 中國結直腸癌篩查與早診早治指南 (2020, 北京). 中國腫瘤, 2021, 30(1): 1-28.
5.	宋潔, 王靜, 張曉嵐. 《2021年美國胃腸病學會結直腸癌篩查指南》解讀. 臨床薈萃, 2021, 36(9): 828-831.
6.	汪曉東, 劉健博, 李立. 數據庫建設第六部分: 結直腸癌分期的標簽與結構化. 中國普外基礎與臨床雜志, 2020, 27(7): 873-879.
7.	汪曉東, 劉健博, 李立. 數據庫建設第五部分?結直腸癌的腫瘤特征—模塊的設計(二). 中國普外基礎與臨床雜志, 2020, 27(4): 483-488.
8.	汪曉東, 劉健博, 李立. 數據庫建設第五部分: 結直腸癌的腫瘤特征—模塊的設計(一). 中國普外基礎與臨床雜志, 2020, 27(3): 345-349.
9.	李海, 李福祥. 胃、十二指腸血吸蟲卵沉積與癌腫關系的探討. 中國血吸蟲病防治雜志, 1989, 1(4): 35-36,47.
10.	宋文沖, 于皆平, 沈磊, 等. 29例胃十二指腸血吸蟲病的內鏡表現及病理特點分析. 中華消化內鏡雜志, 2006, 23(4): 259-262.
11.	Choto ET, Mduluza T, Sibanda EN, et al. Possible association and co-existence of schistosome infection and prostate cancer: A systematic review. Afr J Reprod Health, 2020, 24(4): 185-197.
12.	von Bülow V, Lichtenberger J, Grevelding CG, et al. Does schistosoma mansoni facilitate carcinogenesis? Cells, 2021, 10(8): 1982. doi: 10.3390/cells10081982.
13.	Wu C, Du X, Tang L, et al. Schistosoma japonicum SjE16. 7 protein promotes tumor development via the receptor for advanced glycation end products (RAGE). Front Immunol, 2020, 11: 1767.
14.	張建鐸, 張鳳菊. 家族性腺瘤性息肉病研究進展. 職業與健康, 2000, 16(5): 12-13.
15.	Alruwaii ZI, Chianchiano P, Larman T, et al. Familial adenomatous polyposis-associated traditional serrated adenoma of the small intestine: a clinicopathologic and molecular analysis. Am J Surg Pathol, 2021, 45(12): 1626-1632.
16.	Mohammed N, Rabinovitch PS, Wang D, et al. Nonampullary duodenal adenomas in familial adenomatous polyposis and sporadic patients lack the DNA content abnormality that is characteristic of the adenoma-carcinoma sequence involved in the development of other gastrointestinal malignancies. Am J Surg Pathol, 2021, 45(12): 1694-1702.
17.	Ali Khan U, Fallah M, Tian Y, et al. Personal history of diabetes as important as family history of colorectal cancer for risk of colorectal cancer: a nationwide cohort study. Am J Gastroenterol, 2020, 115(7): 1103-1109.
18.	Docampo E, Martin M, Gangolf M, et al. Heredity and cancer. Rev Med Liege, 2021, 76(5-6): 327-336.
19.	Maletzki C, Hühns M, Bauer I, et al. Suspected hereditary cancer syndromes in young patients: heterogeneous clinical and genetic presentation of colorectal cancers. Oncologist, 2019, 24(7): 877-882.
20.	Parisi A, Cortellini A, Venditti O, et al. Family history of cancer as potential prognostic factor in stage Ⅲ colorectal cancer: a retrospective monoinstitutional study. J Gastrointest Cancer, 2020, 51(3): 1094-1101.
21.	Ramírez-Díaz MDP, Alvarez-Ba?uelos MT, Robaina-Castellanos MS, et al. Association of family history and life habits in the development of colorectal cancer: a matched case-control study in Mexico. Int J Environ Res Public Health, 2021, 18(16): 8633.
22.	吳肇漢, 秦新裕, 姚禮慶, 等. 上海科普大講壇第二十二講(上) 科學認識腸癌的防護與治療. 華東科技, 2013, 2: 74-75.
23.	Ciuc? A, Moldovan R, Pintea S, et al. Screeners vs. Non-screeners for colorectal cancer among people over 50 years of age:factual and psychological discriminants. J Gastrointestin Liver Dis, 2020, 29(4): 529-537.
24.	陳昌遠. 術中結腸鏡在同時性多原發結直腸癌診斷中的價值. 安徽醫學, 2011, 32(6): 759-760.
25.	陳衛紅, 李艷華, 戴寧, 等. 75歲及以上老年患者結腸鏡檢查的臨床特點分析. 中華全科醫師雜志, 2020, 19(12): 1164-1168.
26.	何建軍. 中國人2 025例多原發結直腸癌薈萃分析. 中華胃腸外科雜志, 2006, 9(3): 225-229.
27.	Pikó B, Rahóty P, Krémer I, et al. Detection of multiple colon and rectal tumors during diagnostic treatment and follow-up. Magy Onkol, 2011, 55(4): 244-249.
28.	Sali L, Falchini M, Taddei A, et al. Role of preoperative CT colonography in patients with colorectal cancer. World J Gastroenterol, 2014, 20(14): 3795-3803.
29.	?avlovschi C, Comanda?u M, ?erban D. Specifics of diagnosis and treatment in synchronous colorectal cancers (SCC). Chirurgia (Bucur), 2013, 108(1): 43-45.
30.	杜曉輝, 馮波, 韓加剛, 等. 中低位直腸癌手術消化道重建中國專家共識(2021版). 中國實用外科雜志, 2021, 41(10): 1081-1089.
31.	姚宏偉, 李心翔, 崔龍, 等. 中國結直腸癌手術病例登記數據庫2019年度報告: 一項全國性登記研究. 中國實用外科雜志, 2020, 40(1): 106-110,16.

1. Nguyen LH, Cao Y, Hur J, et al. The sulfur microbial diet is associated with increased risk of early-onset colorectal cancer precursors. Gastroenterology, 2021, 161(5): 1423-1432.
2. Fang C, Yang L, Yu Y, et al. Rectal cancer in West China: younger onset, poor survival, and poor compliance. Dis Colon Rectum, 2021, 64(6): 639-641.
3. Patel SG, Murphy CC, Lieu CH, et al. Early age onset colorectal cancer. Adv Cancer Res, 2021, 151: 1-37.
4. 陳萬青, 李霓, 蘭平, 等. 中國結直腸癌篩查與早診早治指南 (2020, 北京). 中國腫瘤, 2021, 30(1): 1-28.
5. 宋潔, 王靜, 張曉嵐. 《2021年美國胃腸病學會結直腸癌篩查指南》解讀. 臨床薈萃, 2021, 36(9): 828-831.
6. 汪曉東, 劉健博, 李立. 數據庫建設第六部分: 結直腸癌分期的標簽與結構化. 中國普外基礎與臨床雜志, 2020, 27(7): 873-879.
7. 汪曉東, 劉健博, 李立. 數據庫建設第五部分?結直腸癌的腫瘤特征—模塊的設計(二). 中國普外基礎與臨床雜志, 2020, 27(4): 483-488.
8. 汪曉東, 劉健博, 李立. 數據庫建設第五部分: 結直腸癌的腫瘤特征—模塊的設計(一). 中國普外基礎與臨床雜志, 2020, 27(3): 345-349.
9. 李海, 李福祥. 胃、十二指腸血吸蟲卵沉積與癌腫關系的探討. 中國血吸蟲病防治雜志, 1989, 1(4): 35-36,47.
10. 宋文沖, 于皆平, 沈磊, 等. 29例胃十二指腸血吸蟲病的內鏡表現及病理特點分析. 中華消化內鏡雜志, 2006, 23(4): 259-262.
11. Choto ET, Mduluza T, Sibanda EN, et al. Possible association and co-existence of schistosome infection and prostate cancer: A systematic review. Afr J Reprod Health, 2020, 24(4): 185-197.
12. von Bülow V, Lichtenberger J, Grevelding CG, et al. Does schistosoma mansoni facilitate carcinogenesis? Cells, 2021, 10(8): 1982. doi: 10.3390/cells10081982.
13. Wu C, Du X, Tang L, et al. Schistosoma japonicum SjE16. 7 protein promotes tumor development via the receptor for advanced glycation end products (RAGE). Front Immunol, 2020, 11: 1767.
14. 張建鐸, 張鳳菊. 家族性腺瘤性息肉病研究進展. 職業與健康, 2000, 16(5): 12-13.
15. Alruwaii ZI, Chianchiano P, Larman T, et al. Familial adenomatous polyposis-associated traditional serrated adenoma of the small intestine: a clinicopathologic and molecular analysis. Am J Surg Pathol, 2021, 45(12): 1626-1632.
16. Mohammed N, Rabinovitch PS, Wang D, et al. Nonampullary duodenal adenomas in familial adenomatous polyposis and sporadic patients lack the DNA content abnormality that is characteristic of the adenoma-carcinoma sequence involved in the development of other gastrointestinal malignancies. Am J Surg Pathol, 2021, 45(12): 1694-1702.
17. Ali Khan U, Fallah M, Tian Y, et al. Personal history of diabetes as important as family history of colorectal cancer for risk of colorectal cancer: a nationwide cohort study. Am J Gastroenterol, 2020, 115(7): 1103-1109.
18. Docampo E, Martin M, Gangolf M, et al. Heredity and cancer. Rev Med Liege, 2021, 76(5-6): 327-336.
19. Maletzki C, Hühns M, Bauer I, et al. Suspected hereditary cancer syndromes in young patients: heterogeneous clinical and genetic presentation of colorectal cancers. Oncologist, 2019, 24(7): 877-882.
20. Parisi A, Cortellini A, Venditti O, et al. Family history of cancer as potential prognostic factor in stage Ⅲ colorectal cancer: a retrospective monoinstitutional study. J Gastrointest Cancer, 2020, 51(3): 1094-1101.
21. Ramírez-Díaz MDP, Alvarez-Ba?uelos MT, Robaina-Castellanos MS, et al. Association of family history and life habits in the development of colorectal cancer: a matched case-control study in Mexico. Int J Environ Res Public Health, 2021, 18(16): 8633.
22. 吳肇漢, 秦新裕, 姚禮慶, 等. 上海科普大講壇第二十二講(上) 科學認識腸癌的防護與治療. 華東科技, 2013, 2: 74-75.
23. Ciuc? A, Moldovan R, Pintea S, et al. Screeners vs. Non-screeners for colorectal cancer among people over 50 years of age:factual and psychological discriminants. J Gastrointestin Liver Dis, 2020, 29(4): 529-537.
24. 陳昌遠. 術中結腸鏡在同時性多原發結直腸癌診斷中的價值. 安徽醫學, 2011, 32(6): 759-760.
25. 陳衛紅, 李艷華, 戴寧, 等. 75歲及以上老年患者結腸鏡檢查的臨床特點分析. 中華全科醫師雜志, 2020, 19(12): 1164-1168.
26. 何建軍. 中國人2 025例多原發結直腸癌薈萃分析. 中華胃腸外科雜志, 2006, 9(3): 225-229.
27. Pikó B, Rahóty P, Krémer I, et al. Detection of multiple colon and rectal tumors during diagnostic treatment and follow-up. Magy Onkol, 2011, 55(4): 244-249.
28. Sali L, Falchini M, Taddei A, et al. Role of preoperative CT colonography in patients with colorectal cancer. World J Gastroenterol, 2014, 20(14): 3795-3803.
29. ?avlovschi C, Comanda?u M, ?erban D. Specifics of diagnosis and treatment in synchronous colorectal cancers (SCC). Chirurgia (Bucur), 2013, 108(1): 43-45.
30. 杜曉輝, 馮波, 韓加剛, 等. 中低位直腸癌手術消化道重建中國專家共識(2021版). 中國實用外科雜志, 2021, 41(10): 1081-1089.
31. 姚宏偉, 李心翔, 崔龍, 等. 中國結直腸癌手術病例登記數據庫2019年度報告: 一項全國性登記研究. 中國實用外科雜志, 2020, 40(1): 106-110,16.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Relationship between age and preoperative tumor-related characteristics in patients with colorectal cancer: a real-world study based on DACCA

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