Park So Yeon, Lee Hye Seung, Choe Gheeyoung, Chung Jin Haeng, Kim Woo Ho
Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea.
Virchows Arch. 2006 Jul;449(1):40-7. doi: 10.1007/s00428-006-0212-7. Epub 2006 Apr 28.
It has been suggested that right-sided and left-sided colorectal cancer may arise by different mechanisms. However, there have been few studies of mucinous adenocarcinoma (MA) in relation to location. Therefore, we analyzed clinicopathological characteristics, microsatellite instability (MSI), and expression of MUC1, MUC2, MUC5AC mucin core proteins, and p53 by immunohistochemistry in relation to tumor location. Ninety-six consecutive colorectal MAs and ninety-eight nonmucinous adenocarcinomas (nMAs) were investigated. Right-sided MAs, by comparison with those on the left side, were characterized by older age, larger tumor size, lower stage at presentation, peritumoral lymphocytic response, background of serrated adenoma, MSI-H phenotype, higher MUC2 and MUC5AC expression, and lower p53 protein overexpression. Right-sided nMAs, relative to those on the left side, were associated with MSI-H phenotype, higher MUC2 and MUC5AC expression, and lower p53 protein overexpression. Thus, MSI-H phenotype, expression of MUC2 and MUC5AC, and infrequent p53 protein overexpression are associated with right-sided location as well as mucinous histology. In univariate analysis, right-sided location had a favorable effect on disease specific survival of the patients with MA, although it is not an independent predictor of survival. Our results indicate that MA is a distinctive form of colorectal cancer and has different phenotypes depending on tumor location.
有人提出,右半结肠癌和左半结肠癌可能通过不同机制发生。然而,关于黏液腺癌(MA)与肿瘤位置关系的研究较少。因此,我们通过免疫组织化学分析了与肿瘤位置相关的临床病理特征、微卫星不稳定性(MSI)以及MUC1、MUC2、MUC5AC黏蛋白核心蛋白和p53的表达。我们对96例连续性结直肠MA和98例非黏液腺癌(nMA)进行了研究。与左侧的MA相比,右侧的MA具有以下特征:患者年龄较大、肿瘤体积较大、就诊时分期较低、肿瘤周围淋巴细胞反应、锯齿状腺瘤背景、MSI-H表型、MUC2和MUC5AC表达较高以及p53蛋白过表达较低。与左侧的nMA相比,右侧的nMA与MSI-H表型、MUC2和MUC5AC表达较高以及p53蛋白过表达较低相关。因此,MSI-H表型、MUC2和MUC5AC的表达以及p53蛋白过表达罕见与右侧肿瘤位置以及黏液组织学相关。在单因素分析中,右侧肿瘤位置对MA患者的疾病特异性生存有有利影响,尽管它不是生存的独立预测因素。我们的结果表明,MA是结直肠癌的一种独特形式,并且根据肿瘤位置具有不同的表型。
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