Prognostic significance and molecular features of signet-ring cell and mucinous components in colorectal carcinoma.
Prognostic significance and molecular features of signet-ring cell and mucinous components in colorectal carcinoma.
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DOI：
10.1245/s10434-014-4159-7
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发表时间：
2015-04
影响因子：
3.7
通讯作者：
Ogino S
中科院分区：
文献类型：
--
作者：
Inamura K;Yamauchi M;Nishihara R;Kim SA;Mima K;Sukawa Y;Li T;Yasunari M;Zhang X;Wu K;Meyerhardt JA;Fuchs CS;Harris CC;Qian ZR;Ogino S
结直肠癌（Colorectal carcinoma，CRC）是一组组织病理学和分子生物学上具有异质性的疾病，在病理学上可不同程度地含有印戒细胞成分和/或粘液成分。然而，很少有人知道这些成分的预后意义，独立于各种肿瘤分子特征。利用护士健康研究和卫生专业人员随访研究中1,336例直肠癌和结肠癌的分子病理流行病学数据库，我们根据CRC中印戒细胞和粘液成分的比例检查了患者的生存率。使用考克斯比例风险模型计算死亡率的风险比（HR），调整潜在混杂因素，包括分期、微卫星不稳定性、CpG岛甲基化表型、LINE-1甲基化以及KRAS、BRAF和PIK 3CA突变。与不含印戒细胞成分的CRC相比，1- 50%印戒细胞成分与多变量CRC特异性死亡率HR为1.40 [95%置信区间（CI）1.02-1.93]相关，印戒细胞成分> 50%与多变量CRC特异性死亡率HR为4.53（95%CI 2.53-8.12）相关（P趋势> 0.0001）。与不含粘液成分的CRC相比，1- 50%粘液成分（多变量HR 1.04; 95% CI 0.81-1.33）或> 50%粘液成分（多变量HR 0.82; 95% CI 0.54-1.23）均与CRC特异性死亡率无显著相关性（P趋势< 0.57）。即使是CRC中的少量（50%或更少）印戒细胞成分也与较高的患者死亡率相关，与各种肿瘤分子和其他临床病理学特征无关。相反，粘液成分与结直肠癌患者的死亡率无关。
Colorectal carcinoma (CRC) represents a group of histopathologically and molecularly heterogeneous diseases, which may contain signet-ring cell component and/or mucinous component to a varying extent under pathology assessment. However, little is known about the prognostic significance of those components, independent of various tumor molecular features. Utilizing a molecular pathological epidemiology database of 1,336 rectal and colon cancers in the Nurses’ Health Study and the Health Professionals Follow-up Study, we examined patient survival according to the proportion of signet-ring cell and mucinous components in CRCs. Cox proportional hazards models were used to compute hazard ratio (HR) for mortality, adjusting for potential confounders including stage, microsatellite instability, CpG island methylator phenotype, LINE-1 methylation, and KRAS, BRAF, and PIK3CA mutations. Compared to CRC without signet-ring cell component, 1–50 % signet-ring cell component was associated with multivariate CRC-specific mortality HR of 1.40 [95 % confidence interval (CI) 1.02–1.93], and >50 % signet-ring cell component was associated with multivariate CRC-specific mortality HR of 4.53 (95 % CI 2.53–8.12) (Ptrend > 0.0001). Compared to CRC without mucinous component, neither 1–50 % mucinous component (multivariate HR 1.04; 95 % CI 0.81–1.33) nor >50 % mucinous component (multivariate HR 0.82; 95 % CI 0.54–1.23) was significantly associated with CRC-specific mortality (Ptrend < 0.57). Even a minor (50 % or less) signet-ring cell component in CRC was associated with higher patient mortality, independent of various tumor molecular and other clinicopathological features. In contrast, mucinous component was not associated with mortality in CRC patients.
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影响因子：
3.7
作者：
Hyngstrom JR;Hu CY;Xing Y;You YN;Feig BW;Skibber JM;Rodriguez-Bigas MA;Cormier JN;Chang GJ
通讯作者：
Chang GJ
影响因子：
4.3
作者：
Bishehsari, Faraz;Mahdavinia, Mahboobeh;Mariani-Costantini, Renato
通讯作者：
Mariani-Costantini, Renato
影响因子：
7.5
作者：
Kakar, S;Smyrk, TC
通讯作者：
Smyrk, TC
影响因子：
50.5
作者：
Hugen, N.;Verhoeven, R. H. A.;de Wilt, J. H. W.
通讯作者：
de Wilt, J. H. W.
影响因子：
4.3
作者：
Kim, Jung Ho;Kang, Gyeong Hoon
通讯作者：
Kang, Gyeong Hoon