Department of Abdominal Oncology, Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang, P. R. China.
School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, P. R. China.
Cancer Commun (Lond). 2019 Mar 29;39(1):13. doi: 10.1186/s40880-019-0361-0.
Mucinous colorectal adenocarcinoma is a distinct subtype of colorectal cancer (CRC) characterized by the presence of abundant extracellular mucin which accounts for at least 50% of the tumor volume. Mucinous colorectal adenocarcinoma is found in 10%-20% of CRC patients and occurs more commonly in female and younger patients. Moreover, mucinous colorectal adenocarcinoma is more frequently located in the proximal colon and diagnosed at an advanced stage. Based on its molecular context, mucinous colorectal adenocarcinoma is associated with the overexpression of mucin 2 (MUC2) and mucin 5AC (MUC5AC) proteins. At the same time, it shows higher mutation rates in the fundamental genes of the RAS/MAPK and PI3K/Akt/mTOR pathways. Mucinous colorectal adenocarcinoma also shows higher rates of microsatellite instability (MSI) than non-mucinous colorectal adenocarcinoma which might correlate it with Lynch syndrome and the CpG island methylator phenotype. The prognosis of mucinous colorectal adenocarcinoma as to non-mucinous colorectal adenocarcinoma is debatable. Further, the impaired responses of mucinous colorectal adenocarcinoma to palliative or adjuvant chemotherapy warrant more studies to be performed for a specialized treatment for these patients. In this review, we discuss the molecular background and histopathology of mucinous colorectal adenocarcinoma, and provide an update on its prognosis and therapeutics from recent literatures.
黏液型结直肠腺癌是一种独特的结直肠癌(CRC)亚型,其特征是存在丰富的细胞外黏蛋白,至少占肿瘤体积的 50%。黏液型结直肠腺癌在 10%-20%的 CRC 患者中发现,在女性和年轻患者中更为常见。此外,黏液型结直肠腺癌更常发生在近端结肠,且诊断时多处于晚期。基于其分子背景,黏液型结直肠腺癌与黏蛋白 2(MUC2)和黏蛋白 5AC(MUC5AC)蛋白的过度表达有关。同时,它在 RAS/MAPK 和 PI3K/Akt/mTOR 通路的基础基因中显示出更高的突变率。黏液型结直肠腺癌的微卫星不稳定性(MSI)率也高于非黏液型结直肠腺癌,这可能与其林奇综合征和 CpG 岛甲基化表型有关。黏液型结直肠腺癌的预后与非黏液型结直肠腺癌的预后存在争议。此外,黏液型结直肠腺癌对姑息或辅助化疗的反应受损,需要更多的研究来为这些患者制定专门的治疗方法。在这篇综述中,我们讨论了黏液型结直肠腺癌的分子背景和组织病理学,并根据最近的文献更新了其预后和治疗方法。
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