【摘要】 目的 探讨早发性结直肠癌(EO-CRC)的临床病理特征及预后风险因素，为制定地域化分层筛查策略提供依据。方法 回顾性分析2019年1月至2023年12月南方医科大学南方医院984例结直肠癌患者的临床资料，按年龄分为EO-CRC组(<50岁)和LO-CRC组(≥50岁)。采用χ~2检验比较组间临床病理特征，采用单因素及多因素COX回归模型分析EO-CRC预后的影响因素；绘制Kaplan-Meier生存曲线比较两组间的生存差异。结果 EO-CRC组结直肠癌家族史、贫血、化疗、低分化、淋巴结转移EO-CRC组结直肠癌家族史、贫血、化疗、低分化、淋巴结转移比例显著高于LO-CRC组(P均<0.05),而高血压、糖尿病、溃疡型病变、CEA升高、PMS2阳性、MLH1阳性比例显著低于LO-CRC组(P<均0.05)比例显著高于LO-CRC组(P均<0.05),而高血压、糖尿病、溃疡型病变、CEA升高比例显著低于LO-CRC组(P<均0.05)。EO-CRC患者的独立风险因素为结直肠癌家族史、无便血、合并息肉、PMS2阴性(P<0.05)。两组5年累积生存率无显著差异(P>0.05)。结论 EO-CRC更易伴随结直肠癌家族史、低分化、淋巴结转移及错配修复蛋白阴性；结直肠癌家族史、无便血、合并息肉、PMS2阴性是EO-CRC患者预后的独立风险因素。更多还原

【Abstract】 Objective To explore the clinical and pathological characteristics and prognostic risk factors of early-onset colorectal cancer(EO-CRC), providing a basis for developing regional stratified screening strategies. Methods Retrospective analysis of clinical data of 984 patients with colorectal cancer at Nanfang Hospital of Southern Medical University from January 2019 to December 2023, divided by age into EO-CRC group(<50 years old) and LO-CRC group(≥ 50 years old). Using a chi square test to compare the clinical and pathological characteristics between groups, and using univariate and multivariate Cox regression models to analyze the influencing factors of EO-CRC prognosis; Draw Kaplan-Meier survival curves to compare the survival differences between two groups. Results The family history of colorectal cancer, anemia, chemotherapy, poor differentiation and lymph node metastasis rates in EO-CRC group were significantly higher than those in LO-CRC group(all P<0.05),while the proportion of hypertension, diabetes, ulcerative lesions, PMS2 positive and MLH1 positive was significantly lower than that in LO-CRC group(all P<0.05).The independent risk factors for EO-CRC group were family history of colorectal cancer, absence of rectal bleeding, presence of polyps, and PMS2 negativity(P<0.05). There was no significant difference in the 5-year cumulative survival rate between the two groups(P>0.05).Conclusion EO-CRC is more likely to be associated with a family history of colorectal cancer, low differentiation, lymph node metastasis, and negative mismatch repair proteins; Family history of colorectal cancer, absence of rectal bleeding, presence of polyps, and PMS2 negativity are independent risk factors for the prognosis of EO-CRC group.更多还原