Analysis of the clinicopathologic characteristics and prognostic of stage I invasive mucinous adenocarcinoma
Analysis of the clinicopathologic characteristics and prognostic of stage I invasive mucinous adenocarcinoma
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I期浸润性粘液腺癌临床病理特征及预后分析
DOI：
10.1007/s00432-016-2201-9
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发表时间：
2016-08-01
影响因子：
3.6
通讯作者：
Chen, Haiquan
中科院分区：
文献类型：
--
作者：
Luo, Jizhuang;Wang, Rui;Chen, Haiquan
目的I期侵袭性粘液腺癌(IMA)少见，其组织学、临床特征与预后的关系尚未得到深入研究。本研究旨在比较不同粘液成分的IMA患者的预后及辅助化疗对IMA患者的影响。方法145例I期IMA患者和3536例侵袭性非粘液腺癌患者行R0切除。根据肿瘤中粘液型的百分比，IMA可分为两个亚型：单纯粘液型(90%侵袭性粘液型)和粘液/非粘液性混合型(≥各组织成分占10%)。浸润性非粘液性腺癌分为三个亚型：腺泡/乳头状癌(ACN/PAP)和实性/微乳头状癌(SOL/MIP)。结果IMA患者粘液/非粘液混合亚组与单纯粘液亚组无病生存期(DFS)和总生存期(OS)差异无统计学意义(P=0.003)，OS(P=0.514)无明显差异。IMA与浸润性非粘液性腺癌的DFS(p=0.428)和OS(p=0.232)差异无统计学意义。而DFS(P<；0.001)和OS(P<；0.001)在5个主要组织学亚型之间有统计学意义：LEP和单纯IMA预后良好，粘液/非粘液性IMA和SOL/MIP亚型预后最差。结论粘液性/非粘液性混合IMA患者的DFS较单纯粘液性IMA差。早期IMA不能从辅助化疗中获益。
PurposeThe correlations between histological, clinical features and prognosis of stage I invasive mucinous adenocarcinoma (IMA) have not been thoroughly studied for its rare incidence. This study aimed to compare the prognosis among IMA with different percentage of mucinous component and the effect of adjuvant chemotherapy on IMA patients.MethodsA total of 145 stage I IMA and 3536 invasive nonmucinous adenocarcinoma patients with R0 resection were included. Based on the percentage of mucinous pattern presented in tumor, IMA were classified into two subgroups: pure mucinous (>90 % invasive mucinous pattern) and mixed mucinous/nonmucinous (≥10 % of each histologic component). Invasive nonmucinous adenocarcinomas were classified into three subgroups: lepidic (LEP), acinar/papillary (ACN/PAP) and solid/micropapillary (SOL/MIP). Disease-free survival (DFS) and overall survival (OS) were assessed and compared among IMA and invasive nonmucinous patients.ResultsFor IMA patients, DFS (p= 0.003) was worse for mixed mucinous/nonmucinous compared with pure mucinous subgroup, OS (p= 0.514) was not prognostically different between two groups. There were no significant difference for DFS (p= 0.428) and OS (p= 0.232) between IMA and invasive nonmucinous adenocarcinoma. However, statistical significance were seen for DFS (p< 0.001) and OS (p< 0.001) between 5 major histological subgroups: LEP and pure IMA showed excellent prognosis, mixed mucinous/nonmucinous IMA and SOL/MIP subtypes presented the worst prognosis. No significant survival benefit from adjuvant chemotherapy for IMA patients.ConclusionsMixed mucinous/nonmucinous IMA had a worse DFS compared with pure mucinous. Early stage IMA could not benefit from adjuvant chemotherapy.