You Jeng-Fu, Hsieh Ling-Ling, Changchien Chung Rong, Chen Jinn-Shiun, Chen Jim-Ray, Chiang Jy-Ming, Yeh Chien Yuh, Hsieh Pao-Shiu, Fan Chung-Wei, Liu Chun-Ting, Tang Reiping
Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine at Linko, Taiwan.
Clin Cancer Res. 2006 Jul 15;12(14 Pt 1):4244-50. doi: 10.1158/1078-0432.CCR-06-0202.
To compare survival and histologic features of hereditary nonpolyposis colorectal cancer (HNPCC; Lynch syndrome) cases to well-matched sporadic colon cancers from the same patient population.
Between January 1995 and March 2002, a total of 5,138 consecutive patients underwent resection of primary colorectal adenocarcinoma in a single institution. According to the Amsterdam criteria, 56 HNPCC patients were matched to 147 sporadic colorectal cancer (SCRC) with no family history of cancer and with the same gender, tumor location, and age within 3 years. Immunohistochemical analyses were done for MUC1, MUC2, MUC3, and MUC5AC.
The HNPCC group had a marginally significantly better long-term outcome than the SCRC group (P = 0.058). The trend disappeared after adjustment by tumor-node-metastasis stage in a Cox model (P = 0.774). We noted a difference of >50% in the 5-year cancer-specific survival rates of HNPCC- and SCRC-mucinous groups (92% versus 31%, P = 0.0003). Interaction between mucin and HNPCC and its effects on survival were further confirmed by comparing the Cox models with and without interaction terms (hazard ratio, 0.1; P = 0.034 with adjusting stage). Patients with tumors showing dual expression of mucin and MUC1, which appeared in 11% of those with HNPCC and 50% of those with SCRC, had a lower 5-year cancer-specific survival rate than patients without (30% versus 60%; P = 0.004 by log-rank test; P = 0.039 with adjustment for tumor-node-metastasis stage).
These results suggest that mucin has an inverse effect on survival in patients with HNPCC and SCRC, which might be partly explained by a lower prevalence of MUC1 expression in the mucinous HNPCC group than in the SCRC groups.
比较遗传性非息肉病性结直肠癌（HNPCC；林奇综合征）病例与来自同一患者群体的匹配良好的散发性结肠癌的生存率和组织学特征。
1995年1月至2002年3月期间，共有5138例连续患者在单一机构接受了原发性结直肠腺癌切除术。根据阿姆斯特丹标准，56例HNPCC患者与147例无癌症家族史、性别、肿瘤位置相同且年龄在3年内的散发性结直肠癌（SCRC）患者进行匹配。对MUC1、MUC2、MUC3和MUC5AC进行免疫组织化学分析。
HNPCC组的长期预后略好于SCRC组（P = 0.058）。在Cox模型中经肿瘤-淋巴结-转移分期调整后，这种趋势消失（P = 0.774）。我们注意到HNPCC组和SCRC黏液性组的5年癌症特异性生存率相差>50%（92%对31%，P = 0.0003）。通过比较有和无交互项的Cox模型，进一步证实了黏蛋白与HNPCC之间的相互作用及其对生存的影响（风险比，0.1；调整分期后P = 0.034）。肿瘤同时表达黏蛋白和MUC1的患者，在HNPCC患者中占11%，在SCRC患者中占50%，其5年癌症特异性生存率低于无此表达的患者（30%对60%；对数秩检验P = 0.004；调整肿瘤-淋巴结-转移分期后P = 0.039）。
这些结果表明，黏蛋白对HNPCC和SCRC患者的生存有相反影响，这可能部分是由于黏液性HNPCC组中MUC1表达的患病率低于SCRC组。
