Mucinous adenocarcinoma showing different clinicopathological and molecular characteristics in relation to different colorectal cancer subgroups
Mucinous adenocarcinoma showing different clinicopathological and molecular characteristics in relation to different colorectal cancer subgroups
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DOI：
10.1007/s00384-010-0958-x
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发表时间：
2010-08-01
影响因子：
2.8
通讯作者：
Chen, J. R.
中科院分区：
文献类型：
--
作者：
Chiang, J. M.;Yeh, C. Y.;Chen, J. R.
粘液腺癌（MAC）是常见的老年散发性结直肠癌（YSCC）和遗传性非息肉病性结直肠癌（HNPCC）的肿瘤。本研究以1995年1月1日至2001年12月31日在林口长庚医院结直肠癌登记中心登记的82例HNPCC和68例YSCC患者为研究对象，探讨HNPCC患者MAC的临床病理特征与YSCC患者MAC的差异。比较HNPCC和YSCC患者MAC和非MAC的临床病理和分子生物学特征，MAC的低分化率明显高于非MAC（32% vs. 8.2%，p = 0.001），晚期肿瘤分期（76%对47%，p = 0.002），错配修复蛋白（MMR）表达的丧失（74%对44%，p = 0.023），和MUC2表达的增加（98%对61%，p < 0.001）。HNPCC患者的MAC显示出主要的右侧结肠受累，而YSCC患者的MAC显示出主要的左侧结肠受累（79% vs. 22%，p = 0.001）。在非MAC组中，肿瘤分期、MMR表达缺失和MUC1表达增加的差异更为明显，而且MAC组和非MAC组的肿瘤分期均为晚期（81%比62%，p = 0.072）。相反，HNPCC患者MAC和非MAC中MMR表达缺失的发生率无显著差异（86% vs.70%，p = 0.323）。粘液性YSCC（左结肠优势）和粘液性HNPCC（右半结肠优势）之间观察到显著不同的肿瘤定位。
Mucinous adenocarcinoma (MAC) is frequently reported to be associated with patients of young-age sporadic colorectal cancer (YSCC) and hereditary nonpolyposis colorectal cancer (HNPCC). This study is aimed to investigate whether the clinicopathological characteristics of MAC of HNPCC patients are distinct from those of YSCC patients.Eighty-two HNPCC and 68 YSCC patients recorded in the colorectal cancer registry of Chang Gung Memorial Hospital at Linkou, Taiwan, between January 1, 1995 and December 31, 2001 were included in this study. Clinicopathological and molecular variables of MAC and non-MAC of HNPCC and YSCC patients were compared accordingly.Compared to non-MAC, MAC significantly showed higher frequencies of poor differentiation (32% vs. 8.2%, p = 0.001), advanced tumor stage (76% vs. 47%, p = 0.002), loss of mismatch repair protein (MMR) expression (74% vs. 44%, p = 0.023), and increased MUC2 expression (98% vs. 61%, p < 0.001). MAC of HNPCC patients showed predominant right-sided colon involvement, whereas MAC of YSCC patients displayed predominance in the left colon (79% vs. 22%, p = 0.001). Among the non-MAC counterparts, more differences were detectable including tumor stage, loss of MMR expression, and increased MUC1 expression.Furthermore, both MAC and non-MAC of YSCC patients showed higher frequencies of advanced tumor stage (81% vs. 62%, p = 0.072). In contrast, the incidence of loss of MMR expression in MAC and non-MAC of HNPCC patients is not significantly different (86% vs. 70%, p = 0.323).Significantly different tumor localization was observed between mucinous YSCC (left colon predominance) and mucinous HNPCC (right colon predominance).