Department of Surgery, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, Netherlands.
Department of Radiology, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT, UK.
Nat Rev Clin Oncol. 2016 Jun;13(6):361-9. doi: 10.1038/nrclinonc.2015.140. Epub 2015 Sep 1.
The majority of colorectal cancers (CRCs) are classified as adenocarcinoma not otherwise specified (AC). Mucinous carcinoma (MC) is a distinct form of CRC and is found in 10-15% of patients with CRC. MC differs from AC in terms of both clinical and histopathological characteristics, and has long been associated with an inferior response to treatment compared with AC. The debate concerning the prognostic implications of MC in patients with CRC is ongoing and MC is still considered an unfavourable and unfamiliar subtype of the disease. Nevertheless, in the past few years epidemiological and clinical studies have shed new light on the treatment and management of patients with MC. Use of a multidisciplinary approach, including input from surgeons, pathologists, oncologists and radiologists, is beginning to lead to more-tailored approaches to patient management, on an individualized basis. In this Review, the authors provide insight into advances that have been made in the care of patients with MC. The prognostic implications for patients with colon or rectal MC are described separately; moreover, the predictive implications of MC regarding responses to commonly used therapies for CRC, such as chemotherapy, radiotherapy and chemoradiotherapy, and the potential for, and severity of, metastasis are also described.
大多数结直肠癌(CRC)被归类为未特指的腺癌(AC)。黏液腺癌(MC)是 CRC 的一种独特形式,占 CRC 患者的 10-15%。MC 在临床和组织病理学特征方面与 AC 不同,并且长期以来与 AC 相比,其治疗反应较差。关于 MC 在 CRC 患者中的预后意义的争论仍在继续,MC 仍然被认为是一种不利的、不熟悉的疾病亚型。然而,在过去几年中,流行病学和临床研究为 MC 患者的治疗和管理提供了新的见解。多学科方法的应用,包括外科医生、病理学家、肿瘤学家和放射科医生的参与,开始导致根据个体情况对患者管理进行更有针对性的方法。在这篇综述中,作者深入探讨了 MC 患者护理方面的进展。分别描述了结肠或直肠 MC 患者的预后意义;此外,还描述了 MC 对 CRC 常用治疗方法(如化疗、放疗和放化疗)的反应的预测意义,以及转移的可能性和严重程度。