Clinicopathologic Characteristics Of Colorectal Cancer Patients Aged45Years And Younger

Objective:This study was to investigate the clinicopathologic characteristicsimprove the knowledge of the diagnosis and treatment in colorectal cancer (CRC)patients aged45years and younger.Methods:132cases of colorectal cancer patients aged45years and younger inFirst Affiliated Hospital of Dalian Medical University from January2003to January2013were retrospectively reviews and compared with150patients aged60and older60years with colorectal cancer.All of them had received surgery treatment andpathologically confirmed.The general informations (gender,age,family history ofCRC),tumor markers, the first symptom,misdiagnosis and clinicopathological features(including location of tumor,tumor size,macroscopic type,histological grade,histologicaltype,T stage,N stage,M stage,TNM stage,surgical procedure) were analyzed with χ2testin two groups.Results:Youth patients accounted for7.04%of the patients with colorectal cancerover the same period and the median age was38years. Generation aspect: theproportion of the young group is1.16:1, which is lower than the proportion of the oldgroup about1.46:1, but they have no significant difference.Family history of CRCaspect: young patients may have more chance in family history of CRC comparing toold patients. First symptom aspect: hematochezia/mucous bloody stools (48.5%)andabdominal pain and abdominal distention（39.4%）is the most common in the younggroup.The incidence rate of abdominal pain and distention are significantly higher thanthe old group, while the incidence rate of abdominal mass in the young group is significantly lower than the old group. Misdiagnosis:The young patients is significantlyhigher than old patients.Tumor markers:there is no significant difference among the twogroups.Disease site aspect: the young patients are mainly Rectum and sigmoid(80.3%over all) and the incidence of rectal cancer is significantly higher than the old group,while the incidence of right colon cancer is significantly lower than the old group.Tumor size and macroscopic type aspect: the young group have no significantdifference to the old group. Histological type and histological grade aspect:theproportion of mucinous/signet-ring adenocarcinoma and poorly differentiated in youngpatients is significantly higher than old patients.But the proportion of adenocarcinomaand well differentiated in young patients is significantly lower than oldpatients.Pathology TMN aspect: the proportion of T4stage in young patients issignificantly higher than old patients, while the proportion of T2stage is significantlylower than old patients.The proportion of N2stage in young patients is significantlyhigher than old patients, while the proportion of N0stage is significantly lower than oldpatients. The young patients are mainly in Ⅲand Ⅳstage. The old patients are mainlyinⅠandⅡstage.The proportion of young patients in ⅢandⅣstage is significantlyhigher than old patients,but the proportion of young patients inⅡstage is significantlylower than old patients.Therapy aspect: the proportion of palliative surgery in youngpatients is higher than old patients.Conclusion:1.In the first symptom,hematochezia/mucous bloody stools,abdominalpain and abdominal distention is the most common in the young group.Themisdiagnosis rate in the young group is higher. The early diagnosis rate in the younggroup is low.2.Young patients with colorectal cancer has a worse histological differentiation,highermalignant degree,worse TNM stags.