黏液性结直肠癌是一种独特的实体吗？

[Is mucinous colorectal adenocarcinoma a distinct entity?].

作者信息

Adell R, Marcote E, Segarra M A, Pellicer V, Gamón R, Bayón A M, Canales M, Torner A

机构信息

Servicio de Cirugía. Hospital de Vinarós. Castelló. España.

出版信息

Gastroenterol Hepatol. 2002 Nov;25(9):534-40.

PMID:12435303

Abstract

INTRODUCTION

Several publications have demonstrated that mucinous carcinomas of the colon and rectum are associated with certain clinicopathological and genetic peculiarities that distinguish them from non-mucinous carcinomas. The principal aim of this study was to evaluate whether the biological behavior of mucinous carcinomas differs from that of intestinal carcinomas in patients undergoing surgery for colorectal cancer.

PATIENTS

Between January 1993 and December 2000, 215 patients. underwent surgery in our hospital for colorectal cancer. The patients were divided into two groups according to histological type: tumors were intestinal in 169 patients (82%) and mucinous in 36 (17.6%). Patients undergoing non-resective surgery and those with tumors of other histological types (n = 10) were excluded.

RESULTS

The percentage of patients aged less than 50 years in the group with mucinous carcinoma was 19% (7/36) compared with 4% (7/169) in the non-mucinous group (p = 0.001). Regarding presenting symptoms, anemia was more frequent in patients with mucinous carcinoma (18.2% [n = 6] vs 5.7% [n = 8]) and a change in bowel habits was less frequent (15% [n = 5] vs 34.3% [n = 48]; p < 0.05). A total of 63.9% of mucinous carcinomas (n = 23) were located in the proximal colon (cecum, ascending and transverse colon) compared with 21.3% (n = 36) of non-mucinous carcinomas (p < 0.001). Surgical intention was palliative in 41.7% (n = 23.7) of mucinous carcinomas and in 23.7% (n = 40) of non-mucinous carcinomas (p < 0.05). The mean tumoral size was 6.2 2.5 cm in mucinous carcinomas and 4.7 2 in non-mucinous carcinomas (p = 0.001). Patients with mucinous carcinoma presented a higher percentage of nodal and distant metastases and a lower percentage of early stage tumors (p < 0.05). However, no differences were found in survival between the two histological types.

CONCLUSION

Mucinous tumors were more frequently located in the right colon and in patients less than 50 years old and were more likely to be in more advanced stages than non-mucinous tumors but no differences were found in survival according to tumor type.

摘要

引言

多篇文献表明，结直肠癌的黏液腺癌具有某些临床病理和遗传学特征，使其有别于非黏液腺癌。本研究的主要目的是评估黏液腺癌的生物学行为与接受结直肠癌手术患者的肠道腺癌是否不同。

患者

1993年1月至2000年12月期间，215例患者在我院接受了结直肠癌手术。根据组织学类型将患者分为两组：169例（82%）患者的肿瘤为肠道型，36例（17.6%）为黏液型。排除接受非根治性手术的患者以及其他组织学类型肿瘤患者（n = 10）。

结果

黏液腺癌组年龄小于50岁的患者比例为19%（7/36），而非黏液腺癌组为4%（7/169）（p = 0.001）。关于首发症状，黏液腺癌患者贫血更为常见（18.2% [n = 6] 对5.7% [n = 8]），而排便习惯改变则较少见（15% [n = 5] 对34.3% [n = 48]；p < 0.05）。黏液腺癌中共有63.9%（n = 23）位于近端结肠（盲肠、升结肠和横结肠），而非黏液腺癌为21.3%（n = 36）（p < 0.001）。黏液腺癌患者中有41.7%（n = 23.7）的手术目的为姑息性，非黏液腺癌患者中这一比例为23.7%（n = 40）（p < 0.05）。黏液腺癌的平均肿瘤大小为6.2 ± 2.5 cm，非黏液腺癌为4.7 ± 2 cm（p = 0.001）。黏液腺癌患者的区域淋巴结转移和远处转移比例更高，早期肿瘤比例更低（p < 0.05）。然而，两种组织学类型患者的生存率无差异。