Predominant Serrated Molecular Signature in Postcolonoscopy Colorectal Cancer: A Systematic Review and Meta-Analysis.

However, their molecular features have not been systematically reviewed.

然而，它们的分子特征尚未进行系统性回顾。

Methods

We searched PubMed, Embase, and Cochrane Library databases from inception to April 2024.

我们检索了从建库至2024年4月的PubMed、Embase和Cochrane图书馆数据库。

Studies examining the molecular characteristics of PCCRCs, including microsatellite instability (MSI), CpG island methylation phenotype (CIMP), genetic mutations, and chromosomal alterations were regarded as eligible.

研究检查了PCCRCs的分子特征，包括微卫星不稳定性（MSI）、CpG岛甲基化表型（CIMP）、基因突变和染色体改变，被视为符合条件。

Results

In total, 15 studies encompassing 11 cohorts, with 2,143 PCCRC and 19,036 sporadic colorectal cancer (SCRC) cases, were analyzed.

总共分析了15项研究，涵盖11个队列，包括2,143例PCCRC和19,036例散发性结直肠癌（SCRC）病例。

Compared with SCRC, PCCRC was associated with older age (standardized mean difference 0.29, 95% confidence interval[CI] 0.20-0.38) and more proximal lesions (odds ratio [OR] 2.08, 95% CI 1.91-3.63).

与SCRC相比，PCCRC与年龄较大（标准化平均差异0.29，95%置信区间[CI] 0.20-0.38）和更多近端病变（比值比[OR] 2.08，95% CI 1.91-3.63）相关。

Molecularly, PCCRCs were more likely to exhibit MSI (OR 2.28, 95% CI 1.69-3.08), CIMP (OR 2.10, 95% CI 1.39-3.18), and BRAF mutations (OR 1.74, 95% CI 1.22-2.49) but were less likely to exhibit KRAS mutations (OR 0.63, 95% CI 0.45-0.87).

分子水平上，PCCRCs更可能表现出MSI（OR 2.28，95% CI 1.69-3.08）、CIMP（OR 2.10，95% CI 1.39-3.18）和BRAF突变（OR 1.74，95% CI 1.22-2.49），但不太可能表现出KRAS突变（OR 0.63，95% CI 0.45-0.87）。

Furthermore, MSI was strongly correlated with BRAF mutation (OR 9.36, 95% CI 5.11-17.16) and proximal lesions (OR 6.16, 95% CI 3.74-10.16) in a pooled analysis.

此外，在汇总分析中，MSI与BRAF突变（OR 9.36，95% CI 5.11-17.16）和近端病变（OR 6.16，95% CI 3.74-10.16）有很强的相关性。

Although the pooled 5-year overall survivalrate was similar between PCCRC and SCRC cases (hazard ratio1.03, 95% CI 0.64-1.66), PCCRCs exhibited worse survival compared with screening-detected ones (hazard ratio1.65, 95% CI 1.46-1.86).

尽管PCCRC和SCRC病例的汇总5年总生存率相似（风险比1.03，95%置信区间0.64-1.66），但PCCRCs与筛查发现的病例相比显示出更差的生存率（风险比1.65，95%置信区间1.46-1.86）。

Discussion

Clinical and molecular features indicate that PCCRCs are more likely to be associated with the serrated pathway than with SCRC.

临床和分子特征表明，PCCRCs更可能与锯齿途径相关，而不是与SCRC相关。

Enhancing the detection of clinically significant serrated lesions may improve the efficacy of CRC screening.

提高对临床显著锯齿状病变的检测可能提高结直肠癌筛查的效果。