Critical analysis of mucin and signet ring cell as prognostic factors in an Asian population of 2,764 sporadic colorectal cancers
Critical analysis of mucin and signet ring cell as prognostic factors in an Asian population of 2,764 sporadic colorectal cancers
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DOI：
10.1007/s00384-010-1033-3
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发表时间：
2010-10-01
影响因子：
2.8
通讯作者：
Eu, Kong-Weng
中科院分区：
文献类型：
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作者：
Chew, Min-Hoe;Yeo, Shen-Ann Eugene;Eu, Kong-Weng
关于结直肠印戒细胞癌（SRC）和粘液腺癌（MA）的临床病理学特征以及预后和生存率的数据仍然存在。我们对1999年至2005年2,764例散发性结直肠癌患者进行了评估。回顾性分析其临床病理特点。进行单因素分析，并使用Kaplan-Meier方法构建生存曲线。多因素分析显示MA和SRC的发生率分别为6%和1.1%。MA和SRC倾向于发生在年龄<50岁的千分之一货币符号患者中（SRC 33%，MA 22%，普通腺癌（OA）14%，p = 0.001），并且比OA更常见于右侧（MA 30%，SRC 27%，OA 19%，p = 0.001）。SRC倾向于分化差（SRC 77%，MA 26%，OA 6%，p < 0.0001）并且具有较高的复发风险（SRC 40%，MA 26%，OA 6%，p < 0.0001）。SRC和MA更可能具有局部晚期病变（T3/T4; SRC 100%，MA 90%，OA 83%，p = 0.002）和淋巴结转移（SRC 89%，MA 61%，OA 52%，p < 0.0001），并且在诊断时表现为晚期（III/IV期SRC 94%，MA 67%，OA 56%，p < 0.0001）。SRC的5年癌症特异性生存率（CSS; 11.1%，95%置信区间（CI）0-22.9%）低于MA（46.8%，95% CI 38.6-55.0%）和OA（58.7%，95% CI 56.5- 60.9%，p < 0.001）。在多变量分析中，SRC是一个独立的不良预后因素（HR 1.9，95%CI 1.1-3.0），但MA不是。SRC和MA表现出的临床病理特征表明，与OA相比，不同的生物学。在我们的数据集中，SRC的CSS显著较差，而MA的生存率与OA相似。这些特征在亚洲和西方研究报告中相似。然而，亚洲报告表明MA的发生率较低。
Conflicting data on the clinicopathological characteristics as well as prognosis and survival of signet ring cell (SRC) and mucinous adenocarcinomas (MA) of the colorectum persist.Consecutive patients (2,764) with sporadic colorectal cancer from 1999 to 2005 were evaluated. The clinicopathological characteristics of these patients were reviewed. Univariate analysis was performed, and survival curves were constructed using the Kaplan-Meier method. Multivariate analysis assessed independent prognostic factors.The incidence of MA and SRC is 6% and 1.1%, respectively. MA and SRC tend to occur in patients aged a parts per thousand currency sign50 years (SRC 33%, MA 22%, ordinary adenocarcinomas (OA) 14%, p = 0.001) and are more commonly right-sided (MA 30%, SRC 27%, OA 19%, p = 0.001) than OA. SRC tend to be poorly differentiated (SRC 77%, MA 26%, OA 6%, p < 0.0001) and have a higher risk of recurrence (SRC 40%, MA 26%, OA 6%, p < 0.0001). SRC and MA are more likely to have locally advanced lesions (T3/T4; SRC 100%, MA 90%, OA 83%, p = 0.002) and lymph node metastases (SRC 89%, MA 61%, OA 52%, p < 0.0001) and present with an advanced stage at diagnosis (stage III/IV SRC 94%, MA 67%, OA 56%, p < 0.0001). SRC has poorer 5-year cancer-specific survival (CSS; 11.1%, 95% confidence interval (CI) 0-22.9%) compared with MA (46.8%, 95% CI 38.6-55.0%) and OA (58.7%, 95% CI 56.5-60.9%, p < 0.001). In a multivariate analysis, SRC is an independent poor prognostic factor (HR 1.9, 95% CI 1.1-3.0) but MA is not.SRC and MA demonstrate clinicopathologic characteristics suggestive of a different biology compared with OA. In our dataset, SRC has a significantly poorer CSS whereas survival rates for MA are similar to OA. These characteristics are similar in both Asian and Western studies reported. Asian reports however suggest a lower incidence of MA.