PDF(Pubmed)
Abstract：
UNASSIGNED: Clinical guidelines suggest screening of colorectal cancer (CRC) for microsatellite instability (MSI). However, microsatellite instability-high (MSI-H) CRC is not rare in older patients. This study aimed to investigate the prevalence of MSI-H CRC in an unselected population in an age-based manner.
UNASSIGNED: A retrospective analysis of data from patients undergoing radical surgery for CRC was performed. Only cases with results from MSI testing using immunochemistry (IHC) were analyzed. Age-based analyses were performed using two cut-off ages: 50 years. as stated in Amsterdam II guidelines, and 60 years. as outlined in the revised Bethesda criteria.
UNASSIGNED: The study population included 343 (146 female and 197 male) patients with a median age of 70 years (range 21-90 years). The prevalence of MSI-H tumors in the entire cohort was 18.7%. The prevalence of MSI-H CRC was 22.5% in the group ≤50 years vs. 18.2% in the group >50 years using the age limit in the Amsterdam II guidelines. MSI-H CRC was present in 12.6% of the group aged ≤60 years compared to 20.6% in the control group >60 years.
UNASSIGNED: MSI screening of CRC based on age alone is associated with negative selection of a relevant number of cases. MSI-H CRC is also common in elderly patients, who may be negatively selected secondary to an age-based screening algorithm. Following the results of this study, screening based on clinical criteria should be omitted in favor of systematic screening as is already internationally practiced.
UNASSIGNED: A retrospective analysis of data from patients undergoing radical surgery for CRC was performed. Only cases with results from MSI testing using immunochemistry (IHC) were analyzed. Age-based analyses were performed using two cut-off ages: 50 years. as stated in Amsterdam II guidelines, and 60 years. as outlined in the revised Bethesda criteria.
UNASSIGNED: The study population included 343 (146 female and 197 male) patients with a median age of 70 years (range 21-90 years). The prevalence of MSI-H tumors in the entire cohort was 18.7%. The prevalence of MSI-H CRC was 22.5% in the group ≤50 years vs. 18.2% in the group >50 years using the age limit in the Amsterdam II guidelines. MSI-H CRC was present in 12.6% of the group aged ≤60 years compared to 20.6% in the control group >60 years.
UNASSIGNED: MSI screening of CRC based on age alone is associated with negative selection of a relevant number of cases. MSI-H CRC is also common in elderly patients, who may be negatively selected secondary to an age-based screening algorithm. Following the results of this study, screening based on clinical criteria should be omitted in favor of systematic screening as is already internationally practiced.
摘要：
■临床指南建议筛查结直肠癌（CRC）的微卫星不稳定性（MSI）。然而,微卫星不稳定性高（MSI-H）CRC在老年患者中并不罕见。本研究旨在以基于年龄的方式调查未选择人群中MSI-HCRC的患病率。
■对接受CRC根治术患者的数据进行回顾性分析。仅分析具有使用免疫化学(IHC)的MSI测试结果的病例。使用两个截止年龄进行基于年龄的分析：50岁。如阿姆斯特丹II指南所述，和60年。正如修订的贝塞斯达标准中概述的那样。
■研究人群包括343名（146名女性和197名男性）患者，中位年龄为70岁（范围为21-90岁）。整个队列中MSI-H肿瘤的患病率为18.7%。在≤50岁的组中，MSI-HCRC的患病率为22.5％。使用阿姆斯特丹II指南中的年龄限制，>50岁的组中有18.2％。MSI-HCRC存在于年龄≤60岁的组的12.6％，而>60岁的对照组为20.6％。
■仅基于年龄的CRCMSI筛查与相关病例数的阴性选择相关。MSI-HCRC在老年患者中也很常见，谁可能会被否定地选择为次要的基于年龄的筛选算法。根据这项研究的结果，应省略基于临床标准的筛查，而采用国际上已经实行的系统筛查。
■对接受CRC根治术患者的数据进行回顾性分析。仅分析具有使用免疫化学(IHC)的MSI测试结果的病例。使用两个截止年龄进行基于年龄的分析：50岁。如阿姆斯特丹II指南所述，和60年。正如修订的贝塞斯达标准中概述的那样。
■研究人群包括343名（146名女性和197名男性）患者，中位年龄为70岁（范围为21-90岁）。整个队列中MSI-H肿瘤的患病率为18.7%。在≤50岁的组中，MSI-HCRC的患病率为22.5％。使用阿姆斯特丹II指南中的年龄限制，>50岁的组中有18.2％。MSI-HCRC存在于年龄≤60岁的组的12.6％，而>60岁的对照组为20.6％。
■仅基于年龄的CRCMSI筛查与相关病例数的阴性选择相关。MSI-HCRC在老年患者中也很常见，谁可能会被否定地选择为次要的基于年龄的筛选算法。根据这项研究的结果，应省略基于临床标准的筛查，而采用国际上已经实行的系统筛查。
