Microsatellite-unstable mucinous colorectal carcinoma occurring in the elderly: Comparison with medullary type poorly differentiated adenocarcinoma
Microsatellite-unstable mucinous colorectal carcinoma occurring in the elderly: Comparison with medullary type poorly differentiated adenocarcinoma
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DOI：
10.1111/j.1440-1827.2007.02082.x
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发表时间：
2007-04-01
影响因子：
2.2
通讯作者：
Takubo, Kaiyo
中科院分区：
文献类型：
--
作者：
Arai, Tomio;Kasahara, Ichiro;Takubo, Kaiyo
粘液性癌和低分化腺癌具有较高的微卫星不稳定性，且随着年龄的增长其发生率逐渐增加。为探讨微卫星不稳定型黏液癌的临床病理和免疫组织化学特点，并与髓质型低分化腺癌进行比较，研究了15例老年微卫星不稳定型和20例微卫星稳定型粘液性结直肠癌的临床病理特征及粘蛋白核心和hMLH1蛋白的表达，并与23例髓质型低分化腺癌(其中21例为微卫星不稳定型)进行了比较。15例微卫星不稳定癌中13例(87%)无hMLH1表达，而20例微卫星稳定癌中3例(115%)无hMLH1表达(P<；0.01)。微卫星不稳定粘液癌MUC5AC阳性表达的比例(87%)显著高于微卫星稳定粘液癌(45%)(P=0.01)。与微卫星稳定型粘液癌相比，微卫星不稳定型粘液癌与肿瘤近端部位、瘤内及瘤周炎性细胞浸润、MUC5AC表达频繁、淋巴结转移率低、hMLH1蛋白表达缺失率显著相关，与髓质型低分化腺癌相比，除MUC2表达和年龄相关外，差异无统计学意义。提示老年微卫星不稳定性粘液癌与髓质型低分化腺癌具有相同的临床病理和分子生物学特征，hMLH1表达缺失的微卫星不稳定性在这两种癌的发生发展中起重要作用。
Mucinous carcinoma and poorly differentiated adenocarcinoma of the large intestine have a high frequency of microsatellite instability, and their occurrence increases gradually with age. To elucidate the clinicopathological and immunohistochemical features of microsatellite-unstable mucinous carcinoma and compare the tumor with medullary type poorly differentiated adenocarcinoma, the clinicopathological status and expression of mucin core and hMLH1 proteins were studied in 15 microsatellite-unstable and 20 microsatellite-stable mucinous colorectal carcinomas occurring in elderly patients, and compared with 23 cases of medullary type poorly differentiated adenocarcinoma in which 21 cases were microsatellite-unstable. Thirteen (87%) of 15 microsatellite-unstable carcinomas exhibited absent hMLH1 expression compared with three (115%) of 20 microsatellite-stable carcinomas (P < 0.01). The proportion (87%) of positive MUC5AC expression in microsatellite-unstable mucinous carcinoma was significantly higher than that (45%) in microsatellite-stable mucinous carcinoma (P = 0.01). Compared with microsatellite-stable mucinous carcinoma, microsatellite-unstable mucinous carcinomas were significantly associated with a proximal location, intra- and peritumoral inflammatory cell infiltration, frequent MUC5AC expression, a low incidence of lymph node metastasis and absent hMLH1 protein expression, which is not different to medullary type poorly differentiated adenocarcinoma except for MUC2 expression and age-related occurrence. These results suggest that microsatellite-unstable mucinous carcinoma occurring in the elderly shares clinicopathological and molecular features with medullary type poorly differentiated adenocarcinoma and that microsatellite instability with absent hMLH1 expression plays an important role in the development of these two carcinomas.