Genetic instability occurs in the majority of young patients with colorectal cancer.
Replication errors (RER) associated with genetic instability have been found in cancers of several different types and particularly in the tumours of patients with hereditary non-polyposis colorectal cancer (HNPCC). We have here determined the prevalence of such instability in relation to age among patients without HNPCC. Colorectal cancers (CRCs) in the majority of patients 35 years of age or younger exhibited instability (58% of 31 patients), whereas CRCs from patients older than 35 uncommonly did (12% of 158, p < 0.0001). Twelve of the patients under 35 with instability were evaluated for alterations of mismatch repair genes, and five were found to harbour germline mutations. These data suggest that the mechanisms underlying tumour development in young CRC patients differ from those in most older patients, regardless of HNPCC status. The results have important implications for genetic testing and management of young CRC patients and their families.
Liu
B
B
Johns Hopkins Oncology Center, Baltimore, Maryland 21231, USA.
Farrington
S M
SM
Petersen
G M
GM
Hamilton
S R
SR
Parsons
R
R
Papadopoulos
N
N
Fujiwara
T
T
Jen
J
J
Kinzler
K W
KW
Wyllie
A H
AH
Vogelstein
B
B
Dunlop
M G
MG
D000328:Adult; D000368:Aged; D000375:Aging / Q000235:genetics; D001483:Base Sequence; D015179:Colorectal Neoplasms / Q000235:genetics*; D017931:DNA Primers / Q000737:chemistry; D004261:DNA Replication / Q000235:genetics*; D004273:DNA, Neoplasm / Q000032:analysis; D004276:DNA, Satellite / Q000235:genetics*; D004268:DNA-Binding Proteins / Q000235:genetics; D005656:Fungal Proteins; D018095:Germ-Line Mutation; D006801:Humans; D008875:Middle Aged; D008969:Molecular Sequence Data; D051718:MutS Homolog 2 Protein; D015995:Prevalence
D017931:DNA Primers; D004273:DNA, Neoplasm; D004276:DNA, Satellite; D004268:DNA-Binding Proteins; D005656:Fungal Proteins; D051718:MutS Homolog 2 Protein