Chand M, Yu S, Swift R I, Brown G
Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK,
Tech Coloproctol. 2014 Apr;18(4):335-44. doi: 10.1007/s10151-013-1099-3. Epub 2013 Dec 11.
The definition of mucinous tumours relies on quantification of the amount of mucus produced by neoplastic cells within the rectum. This has changed over the years to include varying degrees of mucin production. The inconsistency of diagnosis has led to conflicting reports in the literature regarding clinical outcomes and treatment response. A universally accepted definition and improved imaging and surgical techniques in the last decade are now challenging the traditional view of these tumours. The aim of this review was to present the current evidence on the clinicopathological characteristics of mucinous tumours of the rectum.
A systematic review was conducted using Preferred Reporting for Systematic Reviews and Meta-Analyses guidelines. A literature search was performed using the Ovid SP to search both EMBASE and MEDLINE databases, Google Scholar and PubMed to find all studies relating to mucinous carcinoma of the rectum. The search dates were between 1 January 1965 and 1 March 2013.
Mucinous tumours comprise 5-20 % of all rectal cancers and commonly present at a more advanced stage and in younger patients. They are readily identified on MRI, and the diagnosis is confirmed on histological analysis, demonstrating more than 50 % of extracellular mucin within the tumour complex. They carry an overall worse prognosis compared to adenocarcinoma of the same stage. The response to oncological treatment remains controversial.
Mucinous tumours of the rectum are less well understood than non-mucinous adenocarcinoma. This is due to the inconsistent histopathological definitions of the past making comparison of clinical outcome data difficult. They remain challenging to treat and are associated with a poor prognosis. A universally accepted definition and the role of imaging techniques such as MRI to accurately detect mucinous tumours are likely to lead to a better understanding of these cancers.
黏液性肿瘤的定义依赖于对直肠内肿瘤细胞产生黏液量的量化。多年来，这一定义已发生变化，涵盖了不同程度的黏蛋白产生情况。诊断的不一致导致文献中关于临床结局和治疗反应的报道相互矛盾。过去十年中普遍接受的定义以及改进的影像学和手术技术，正挑战着对这些肿瘤的传统看法。本综述的目的是介绍目前关于直肠黏液性肿瘤临床病理特征的证据。
按照系统评价和荟萃分析的首选报告规范进行系统评价。使用Ovid SP在EMBASE和MEDLINE数据库、谷歌学术和PubMed中进行文献检索，以查找所有与直肠黏液腺癌相关的研究。检索日期为1965年1月1日至2013年3月1日。
黏液性肿瘤占所有直肠癌的5%-20%，通常在更晚期且在较年轻患者中出现。它们在MRI上易于识别，通过组织学分析确诊，显示肿瘤复合体中细胞外黏液超过50%。与同阶段腺癌相比，其总体预后更差。对肿瘤治疗的反应仍存在争议。
与非黏液性腺癌相比，直肠黏液性肿瘤的了解较少。这是由于过去组织病理学定义不一致，使得临床结局数据难以比较。它们的治疗仍然具有挑战性，且预后较差。一个普遍接受的定义以及MRI等成像技术在准确检测黏液性肿瘤方面的作用，可能会使人们对这些癌症有更好的理解。
