The surgical treatment of common hereditary colorectal cancer

doi:10.3877/cma.j.issn.2095-3224.2017.03.015

Abstract

Abstract:

The incidence and mortality of colorectal cancer in China are increasing year by year, of which 5% to 6% of are hereditary colorectal cancer. Hereditary colorectal cancer has the characteristics of hereditary, familial aggregation, high incidence, multiple incidence and multiple organ tumors and so on, which threaten our life and lead to death. Family of mutation carriers are at significantly greater risk of developing colorectal cancer than the general population. Early screening and intervention can reduce the risk of cancer. Here we summarize the clinical and genetic characteristics of hereditary colorectal cancer syndrome (Lynch Syndrome and Familial Adenomatous Polyposis), and overview the surgical treatment, genetic testing and screening so as to provide the basis for surgeons choosing the medical methods to take accurate intervention and screening measures and reduce the risk of cancer.

Key words: Colorectal neoplasms, Surgical procedures, operative, Hereditary colorectal cancer, Lynch syndrome, Familial adenomatous polyposis, Precision medicine

Keranmu Adili, Fangqi Liu, Ye Xu. The surgical treatment of common hereditary colorectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2017, 06(03): 243-248.

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References 35

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分型	腺瘤息肉数（枚）	发病年龄（岁）	平均癌变年龄（岁）	癌变率（%）
CFAP	?	?	?	?
严重型	>1 000	≤20	34	100
中间型	100~1 000	10~30	42	?
AFAP	<100	30~50	50~55	69

分型	腺瘤息肉数（枚）	发病年龄（岁）	平均癌变年龄（岁）	癌变率（%）
CFAP	?	?	?	?
严重型	>1 000	≤20	34	100
中间型	100~1 000	10~30	42	?
AFAP	<100	30~50	50~55	69

?	TPC	IPAA	IRA
未来肿瘤发生	无	息肉：常见	息肉：常见
?	?	癌：少见	癌：2~12%
未来随访监护	无	每年检查Pouch和肛管	每年检查直肠
并发症	并发症多	并发症少	并发症少
?	性功能降低	性功能降低	?
?	生育功能降低	生育功能降低	?
生活质量	永久造瘘	肛门功能因人而异	肛门功能好

?	TPC	IPAA	IRA
未来肿瘤发生	无	息肉：常见	息肉：常见
?	?	癌：少见	癌：2~12%
未来随访监护	无	每年检查Pouch和肛管	每年检查直肠
并发症	并发症多	并发症少	并发症少
?	性功能降低	性功能降低	?
?	生育功能降低	生育功能降低	?
生活质量	永久造瘘	肛门功能因人而异	肛门功能好

组别	直肠息肉	IRA（%）	中位随访时间（年）	二次直肠切除术（%）	癌变率（%）
1	0~5	93	12	6	0
2	6~19	92	11	5	3.7
3	≥20	50	18	35	11

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