Lam Alfred King-Yin, Ong Kate, Ho Yik-Hong
Division of Pathology, Griffith Medical School, Medicine and Oral Health Center, PMB 50 GCMC Bundall, Gold Coast, Queensland 9726, Australia.
Dis Colon Rectum. 2006 Sep;49(9):1275-83. doi: 10.1007/s10350-006-0650-y.
This study was designed to examine the clinicopathologic features and p53 and p16 expressions in colorectal mucinous adenocarcinoma and colorectal signet-ring cell carcinoma.
The clinicopathologic features of 36 patients with colorectal mucinous adenocarcinoma and colorectal signet-ring cell carcinoma were analyzed and compared with 228 patients with colorectal adenocarcinomas. The p53 and p16 expressions in the colorectal mucinous adenocarcinoma and colorectal signet-ring cell carcinoma were studied by immunohistochemistry.
Colorectal mucinous adenocarcinoma and colorectal signet-ring cell carcinoma accounted for 14 percent of colorectal cancer. The median age at presentation was 67 years. Family history of colorectal cancer in their first-degree relatives was seen in 14 percent of these patients. Fifty-six percent of the carcinomas were located in the proximal colorectum, most commonly in the transverse colon. Two patients had ulcerative colitis. Compared with the usual colorectal adenocarcinoma, colorectal mucinous adenocarcinoma and colorectal signet-ring cell carcinoma was found more often in proximal colorectum (P = 0.002), larger (P = 0.05), and in advanced stages (P = 0.018). Forty-four percent (n = 16) of the colorectal mucinous adenocarcinoma and colorectal signet-ring cell carcinoma showed p53 expression. All the patients with colorectal mucinous adenocarcinoma and colorectal signet-ring cell carcinoma with a positive family history of colorectal adenocarcinoma had tumors that showed p53 expression (P = 0.012). Seventy-eight percent (n = 28) of the tumors showed p16 expression. The median survival of the patients with these tumors was 23 months. The survival of these patients with colorectal mucinous adenocarcinoma and colorectal signet-ring cell carcinoma was poorer if the lesions were of advanced stages (P = 0.023) or with family history of colorectal cancer (P = 0.0015). Also, patients with colorectal mucinous adenocarcinoma and colorectal signet-ring cell carcinoma that did not express p16 and p53 had better survival than other patients (P = 0.04).
Colorectal mucinous adenocarcinoma and colorectal signet-ring cell carcinoma had distinctive clinicopathologic features. Tumor staging, family history of colorectal cancer, and status of p53 and p16 expressions might predict prognosis in these patients.
本研究旨在探讨结直肠黏液腺癌和结直肠印戒细胞癌的临床病理特征以及p53和p16的表达情况。
分析36例结直肠黏液腺癌和结直肠印戒细胞癌患者的临床病理特征，并与228例结直肠腺癌患者进行比较。采用免疫组织化学方法研究结直肠黏液腺癌和结直肠印戒细胞癌中p53和p16的表达情况。
结直肠黏液腺癌和结直肠印戒细胞癌占结直肠癌的14%。就诊时的中位年龄为67岁。这些患者中有14%的一级亲属有结直肠癌家族史。56%的癌位于结直肠近端，最常见于横结肠。2例患者患有溃疡性结肠炎。与普通结直肠腺癌相比，结直肠黏液腺癌和结直肠印戒细胞癌更常发生于结直肠近端（P = 0.002），体积更大（P = 0.05），且处于晚期（P = 0.018）。44%（n = 16）的结直肠黏液腺癌和结直肠印戒细胞癌显示p53表达。所有有结直肠腺癌家族史阳性的结直肠黏液腺癌和结直肠印戒细胞癌患者的肿瘤均显示p53表达（P = 0.012）。78%（n = 28）的肿瘤显示p16表达。这些肿瘤患者的中位生存期为23个月。如果病变处于晚期（P = 0.023）或有结直肠癌家族史（P = 0.0015），这些结直肠黏液腺癌和结直肠印戒细胞癌患者的生存期较差。此外，不表达p16和p53的结直肠黏液腺癌和结直肠印戒细胞癌患者的生存期比其他患者更好（P = 0.04）。
结直肠黏液腺癌和结直肠印戒细胞癌具有独特的临床病理特征。肿瘤分期、结直肠癌家族史以及p53和p16的表达状态可能预测这些患者的预后。
