Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, Graz, Austria.
Histopathology. 2012 Jun;60(7):1060-72. doi: 10.1111/j.1365-2559.2011.04155.x. Epub 2012 Feb 20.
To analyse the prognostic impact of mucinous differentiation in colorectal mucinous adenocarcinomas and adenocarcinomas with a mucinous component.
A total of 381 tumours were reviewed for mucinous differentiation by two independent pathologists. Mismatch repair status was assessed by immunohistochemistry. Prognostic significance was assessed by univariate and multivariate analyses. Eighty-one (21%) tumours were Union Internationale Contre le Cancer (UICC) Stage I, 120 (31%) Stage II, 126 (33%) Stage III and 54 (14%) Stage IV. Mucinous adenocarcinomas accounted for 12% and adenocarcinomas with a mucinous component for 19% of tumours. Mucinous differentiation was associated significantly with mismatch repair protein deficiency. The presence of extracellular mucin, regardless of extent, did not affect patients' outcome, while tumour grade, vascular and perineural invasion, tumour border configuration and budding were associated significantly with outcome. Cox analysis proved venous invasion to be an independent predictor of outcome in mucinous adenocarcinomas and both venous invasion and tumour budding as independent predictors of outcome in adenocarcinomas with any amount of mucin.
Mucinous adenocarcinomas and/or adenocarcinomas with mucinous component do not differ from conventional adenocarcinomas with respect to prognosis and histological predictors of outcome. Hence, recording of mucinous differentiation may be used as an indicator of mismatch repair deficiency, but not for prognostic stratification.
分析结直肠黏液腺癌和黏液腺癌中黏液分化的预后影响。
由两名独立的病理学家对 381 例肿瘤进行黏液分化评估。通过免疫组织化学评估错配修复状态。通过单因素和多因素分析评估预后意义。81 例（21%）为 UICC 分期 I 期，120 例（31%）为 II 期，126 例（33%）为 III 期，54 例（14%）为 IV 期。黏液腺癌占肿瘤的 12%，黏液腺癌占肿瘤的 19%。黏液分化与错配修复蛋白缺乏显著相关。无论程度如何，细胞外黏液的存在并不影响患者的预后，而肿瘤分级、血管和神经周围侵犯、肿瘤边界形态和芽生与预后显著相关。Cox 分析证明静脉侵犯是黏液腺癌预后的独立预测因子，静脉侵犯和肿瘤芽生是任何程度黏液的腺癌预后的独立预测因子。
黏液腺癌和/或含有黏液的腺癌在预后和预测预后的组织学指标方面与常规腺癌无差异。因此，记录黏液分化可作为错配修复缺陷的指标，但不能用于预后分层。
