Xie Lin, Villeneuve Paul J, Shaw Amanda
Chronic Disease Surveillance Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario K1A 0K9, Canada.
Int J Oncol. 2009 Apr;34(4):1109-15. doi: 10.3892/ijo_00000238.
Previous studies have shown conflicting results on the prognosis of colorectal mucinous adenocarcinoma. This study compared prognostic characteristics of patients diagnosed with mucinous and non-mucinous adenocarcinomas in a Canadian series. Analyses were based on 165 colorectal mucinous and 1215 non-mucinous adenocarcinoma patients who were registered at the Ottawa Regional Cancer Centre from 1994 to 1997, with follow-up extending to December 31, 2001. Differences in survival were examined using the relative survival analysis and the Cox proportional hazards model. For colon, rectum and both combined, the distribution for age at diagnosis, stage and treatment of patients with mucinous adenocarcinoma was similar to that of non-mucinous patients (all p > or = 0.12). Patients with mucinous histology had fewer well- or moderately-differentiated tumours than non-mucinous patients (all p < 0.01). Overall, no statistically significant differences were noted in 5-year relative survival between mucinous and non-mucinous carcinoma for colon, rectum and their combination (p > or = 0.35 for each). However, when the stages were considered separately, patients with stage III mucinous carcinoma had worse survival than patients with non-mucinous carcinoma for both sites. Multivariate analysis of combined data for colon and rectal cancers indicated that independent significant prognostic factors were stage for mucinous, with age and grade as well as stage for non-mucinous carcinoma. In conclusion, no significant differences in stage distribution and overall survival were found between mucinous and non-mucinous patients for colorectal cancer.
以往的研究在结直肠黏液腺癌的预后方面呈现出相互矛盾的结果。本研究比较了加拿大一组被诊断为黏液腺癌和非黏液腺癌患者的预后特征。分析基于1994年至1997年在渥太华地区癌症中心登记的165例结直肠黏液腺癌患者和1215例非黏液腺癌患者,随访至2001年12月31日。使用相对生存分析和Cox比例风险模型检查生存率的差异。对于结肠癌、直肠癌以及两者合并的情况,黏液腺癌患者在诊断年龄、分期和治疗方面的分布与非黏液腺癌患者相似(所有p≥0.12)。黏液组织学类型的患者中高分化或中分化肿瘤比非黏液腺癌患者少(所有p<0.01)。总体而言,结肠癌、直肠癌及其合并情况的黏液腺癌和非黏液腺癌患者的5年相对生存率没有统计学上的显著差异(每种情况p≥0.35)。然而,当分别考虑分期时,III期黏液腺癌患者在两个部位的生存率均低于非黏液腺癌患者。对结肠癌和直肠癌合并数据的多变量分析表明,独立的显著预后因素对于黏液腺癌是分期,对于非黏液腺癌是年龄、分级以及分期。总之,结直肠癌的黏液腺癌和非黏液腺癌患者在分期分布和总生存率方面未发现显著差异。