{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:07:34Z","timestamp":1788826054512,"version":"build-2803163510"},"reference-count":44,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Guandong Medical Research Fund","award":["A2022067"],"award-info":[{"award-number":["A2022067"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early-onset colorectal cancer (CRC) is characterized by distinct molecular and clinical features, a more advanced stage at diagnosis, and unique challenges in clinical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to characterize the clinicopathologic features of early-onset CRC and investigate the associations between clinicopathologic characteristics and genetic mutations in young Chinese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In total, 239 young Chinese patients (age range: 22-45 years) diagnosed with CRC who underwent surgery from January 2016 to June 2022 were retrospectively enrolled.\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">NRAS<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"yes\">BRAF<\/jats:italic>\n                      mutations were detected using a mutation analysis panel kit. Mismatch repair (MMR) protein (MLH, PMS2, MSH2, MSH6) expression was evaluated by immunohistochemistry. Pearson's chi-squared test was used to assess the relationships of genetic mutations and MMR with patients\u2019 clinicopathologic characteristics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      \/\n                      <jats:italic toggle=\"yes\">NRAS<\/jats:italic>\n                      \/\n                      <jats:italic toggle=\"yes\">BRAF<\/jats:italic>\n                      mutation rate was 50.6% (121\/239), including individual rates of 44.4% (\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      ), 2.1% (\n                      <jats:italic toggle=\"yes\">NRAS<\/jats:italic>\n                      ), and 4.2% (\n                      <jats:italic toggle=\"yes\">BRAF<\/jats:italic>\n                      ). In addition, 15.1% of the patients (36\/239) were MMR-deficient (dMMR). The\n                      <jats:italic toggle=\"yes\">BRAF<\/jats:italic>\n                      V600E mutation was significantly associated with high grade (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.012). Similarly, dMMR status showed significant associations with larger tumor size (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.028), tumor location (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), the absence of lymph node metastasis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.001), and the absence of distant metastasis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.038).\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      mutations were more frequent in dMMR tumors than in MMR-proficient tumors (63.8% vs 40.8%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Genetic mutations in the RAS\/RAF pathway and dMMR status are associated with distinct clinicopathological features in patients with early-onset CRC. dMMR is a potentially favorable prognostic marker.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10668969261457880","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T09:04:47Z","timestamp":1781255087000},"page":"1791-1799","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["KRAS\/NRAS\/BRAF Mutations and Mismatch Repair Deficiency in Patients with Early-Onset Colorectal Cancer: A Clinicopathological Analysis"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7220-2855","authenticated-orcid":false,"given":"Chao","family":"Liu","sequence":"first","affiliation":[{"name":"Southern Medical 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