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

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.	陈万青, 李霓, 兰平, 等. 中国结直肠癌筛查与早诊早治指南 (2020, 北京). 中国肿瘤, 2021, 30(1): 1-28.
5.	宋洁, 王静, 张晓岚. 《2021年美国胃肠病学会结直肠癌筛查指南》解读. 临床荟萃, 2021, 36(9): 828-831.
6.	汪晓东, 刘健博, 李立. 数据库建设第六部分: 结直肠癌分期的标签与结构化. 中国普外基础与临床杂志, 2020, 27(7): 873-879.
7.	汪晓东, 刘健博, 李立. 数据库建设第五部分•结直肠癌的肿瘤特征—模块的设计(二). 中国普外基础与临床杂志, 2020, 27(4): 483-488.
8.	汪晓东, 刘健博, 李立. 数据库建设第五部分: 结直肠癌的肿瘤特征—模块的设计(一). 中国普外基础与临床杂志, 2020, 27(3): 345-349.
9.	李海, 李福祥. 胃、十二指肠血吸虫卵沉积与癌肿关系的探讨. 中国血吸虫病防治杂志, 1989, 1(4): 35-36,47.
10.	宋文冲, 于皆平, 沈磊, 等. 29例胃十二指肠血吸虫病的内镜表现及病理特点分析. 中华消化内镜杂志, 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.	张建铎, 张凤菊. 家族性腺瘤性息肉病研究进展. 职业与健康, 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-Bañuelos 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.	吴肇汉, 秦新裕, 姚礼庆, 等. 上海科普大讲坛第二十二讲(上) 科学认识肠癌的防护与治疗. 华东科技, 2013, 2: 74-75.
23.	Ciucă 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.	陈昌远. 术中结肠镜在同时性多原发结直肠癌诊断中的价值. 安徽医学, 2011, 32(6): 759-760.
25.	陈卫红, 李艳华, 戴宁, 等. 75岁及以上老年患者结肠镜检查的临床特点分析. 中华全科医师杂志, 2020, 19(12): 1164-1168.
26.	何建军. 中国人2 025例多原发结直肠癌荟萃分析. 中华胃肠外科杂志, 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.	Şavlovschi C, Comandaşu M, Şerban D. Specifics of diagnosis and treatment in synchronous colorectal cancers (SCC). Chirurgia (Bucur), 2013, 108(1): 43-45.
30.	杜晓辉, 冯波, 韩加刚, 等. 中低位直肠癌手术消化道重建中国专家共识(2021版). 中国实用外科杂志, 2021, 41(10): 1081-1089.
31.	姚宏伟, 李心翔, 崔龙, 等. 中国结直肠癌手术病例登记数据库2019年度报告: 一项全国性登记研究. 中国实用外科杂志, 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. 陈万青, 李霓, 兰平, 等. 中国结直肠癌筛查与早诊早治指南 (2020, 北京). 中国肿瘤, 2021, 30(1): 1-28.
5. 宋洁, 王静, 张晓岚. 《2021年美国胃肠病学会结直肠癌筛查指南》解读. 临床荟萃, 2021, 36(9): 828-831.
6. 汪晓东, 刘健博, 李立. 数据库建设第六部分: 结直肠癌分期的标签与结构化. 中国普外基础与临床杂志, 2020, 27(7): 873-879.
7. 汪晓东, 刘健博, 李立. 数据库建设第五部分•结直肠癌的肿瘤特征—模块的设计(二). 中国普外基础与临床杂志, 2020, 27(4): 483-488.
8. 汪晓东, 刘健博, 李立. 数据库建设第五部分: 结直肠癌的肿瘤特征—模块的设计(一). 中国普外基础与临床杂志, 2020, 27(3): 345-349.
9. 李海, 李福祥. 胃、十二指肠血吸虫卵沉积与癌肿关系的探讨. 中国血吸虫病防治杂志, 1989, 1(4): 35-36,47.
10. 宋文冲, 于皆平, 沈磊, 等. 29例胃十二指肠血吸虫病的内镜表现及病理特点分析. 中华消化内镜杂志, 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. 张建铎, 张凤菊. 家族性腺瘤性息肉病研究进展. 职业与健康, 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-Bañuelos 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. 吴肇汉, 秦新裕, 姚礼庆, 等. 上海科普大讲坛第二十二讲(上) 科学认识肠癌的防护与治疗. 华东科技, 2013, 2: 74-75.
23. Ciucă 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. 陈昌远. 术中结肠镜在同时性多原发结直肠癌诊断中的价值. 安徽医学, 2011, 32(6): 759-760.
25. 陈卫红, 李艳华, 戴宁, 等. 75岁及以上老年患者结肠镜检查的临床特点分析. 中华全科医师杂志, 2020, 19(12): 1164-1168.
26. 何建军. 中国人2 025例多原发结直肠癌荟萃分析. 中华胃肠外科杂志, 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. Şavlovschi C, Comandaşu M, Şerban D. Specifics of diagnosis and treatment in synchronous colorectal cancers (SCC). Chirurgia (Bucur), 2013, 108(1): 43-45.
30. 杜晓辉, 冯波, 韩加刚, 等. 中低位直肠癌手术消化道重建中国专家共识(2021版). 中国实用外科杂志, 2021, 41(10): 1081-1089.
31. 姚宏伟, 李心翔, 崔龙, 等. 中国结直肠癌手术病例登记数据库2019年度报告: 一项全国性登记研究. 中国实用外科杂志, 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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