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黏液型结直肠腺癌:临床病理与治疗选择。

Mucinous colorectal adenocarcinoma: clinical pathology and treatment options.

机构信息

Department of Abdominal Oncology, Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang, P. R. China.

School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, P. R. China.

出版信息

Cancer Commun (Lond). 2019 Mar 29;39(1):13. doi: 10.1186/s40880-019-0361-0.


DOI:10.1186/s40880-019-0361-0
PMID:30922401
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6440160/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e3/6440160/23d1a12d3848/40880_2019_361_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e3/6440160/5ac658d147e1/40880_2019_361_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e3/6440160/ec2dfce282d1/40880_2019_361_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e3/6440160/23d1a12d3848/40880_2019_361_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e3/6440160/5ac658d147e1/40880_2019_361_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e3/6440160/ec2dfce282d1/40880_2019_361_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6e3/6440160/23d1a12d3848/40880_2019_361_Fig3_HTML.jpg

相似文献

[1]
Mucinous colorectal adenocarcinoma: clinical pathology and treatment options.

Cancer Commun (Lond). 2019-3-29

[2]
Mucinous differentiation in colorectal cancer: molecular, histological and clinical aspects.

Acta Chir Belg. 2013

[3]
Prognostic Implications of Mucinous Differentiation in Metastatic Colorectal Carcinoma Can Be Explained by Distinct Molecular and Clinicopathologic Characteristics.

Clin Colorectal Cancer. 2018-7-17

[4]
Meta-analysis of the molecular associations of mucinous colorectal cancer.

Br J Surg. 2019-4-4

[5]
Mucinous phenotype and CD10 expression of primary adenocarcinoma of the small intestine.

World J Gastroenterol. 2015-3-7

[6]
MUC5AC hypomethylation is a predictor of microsatellite instability independently of clinical factors associated with colorectal cancer.

Int J Cancer. 2015-6-15

[7]
Microsatellite-unstable mucinous colorectal carcinoma occurring in the elderly: comparison with medullary type poorly differentiated adenocarcinoma.

Pathol Int. 2007-4

[8]
The molecular background of mucinous carcinoma beyond MUC2.

J Pathol Clin Res. 2014-11-5

[9]
Association of pathway mutation with survival after recurrence in colorectal cancer patients treated with adjuvant fluoropyrimidine and oxaliplatin chemotherapy.

BMC Cancer. 2019-5-6

[10]
Clinicopathological characteristics, microsatellite instability, and expression of mucin core proteins and p53 in colorectal mucinous adenocarcinomas in relation to location.

Virchows Arch. 2006-7

引用本文的文献

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World J Gastrointest Surg. 2025-7-27

[2]
Prognostic and therapeutic value of a 23-gene risk score tailored to the molecular characteristics of mucinous colorectal cancer.

Br J Cancer. 2025-7-2

[3]
Simvastatin inhibits proliferation and migration, promotes oxidative stress and ferroptosis in colon cancer.

World J Gastrointest Oncol. 2025-5-15

[4]
PIWIL2 downregulation in colon cancer promotes transposon activity and pro-tumorigenic phenotypes.

bioRxiv. 2025-5-24

[5]
Case report: Coexistence of rectal signet ring cell carcinoma with neuroendocrine components.

BMC Geriatr. 2025-5-28

[6]
Transcriptomic Landscape of Colorectal Mucinous Adenocarcinoma has Similarity with Intestinal Goblet Cell Differentiation.

Curr Genomics. 2025

[7]
AKR1B1 Expression in the Colorectal Tumor Microenvironment Contributes Towards Its Prognostic Significance.

Cancer Med. 2025-5

[8]
Imaging of young-onset colorectal cancer: what the radiologist needs to know.

Abdom Radiol (NY). 2025-5-17

[9]
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Surg Endosc. 2025-5

[10]
EGF-Upregulated lncRNA ESSENCE Promotes Colorectal Cancer Growth through Stabilizing CAD and Ferroptosis Defense.

Research (Wash D C). 2025-4-3

本文引用的文献

[1]
Advanced Mucinous Colorectal Cancer: Epidemiology, Prognosis and Efficacy of Chemotherapeutic Treatment.

Digestion. 2018-6-5

[2]
Clinical activity and molecular correlates of response to atezolizumab alone or in combination with bevacizumab versus sunitinib in renal cell carcinoma.

Nat Med. 2018-6-4

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Durable Clinical Benefit With Nivolumab Plus Ipilimumab in DNA Mismatch Repair-Deficient/Microsatellite Instability-High Metastatic Colorectal Cancer.

J Clin Oncol. 2018-1-20

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Eur J Pharm Biopharm. 2017-9-30

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Nivolumab in patients with metastatic DNA mismatch repair-deficient or microsatellite instability-high colorectal cancer (CheckMate 142): an open-label, multicentre, phase 2 study.

Lancet Oncol. 2017-9

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Effect of First-Line Chemotherapy Combined With Cetuximab or Bevacizumab on Overall Survival in Patients With KRAS Wild-Type Advanced or Metastatic Colorectal Cancer: A Randomized Clinical Trial.

JAMA. 2017-6-20

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Prognostic and predictive value of primary tumour side in patients with RAS wild-type metastatic colorectal cancer treated with chemotherapy and EGFR directed antibodies in six randomized trials.

Ann Oncol. 2017-8-1

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Genetic variants of mucins: unexplored conundrum.

Carcinogenesis. 2017-7-1

[9]
Mucinous Rectal Adenocarcinoma Is Associated with a Poor Response to Neoadjuvant Chemoradiotherapy: A Systematic Review and Meta-analysis.

Dis Colon Rectum. 2016-12

[10]
Treatment preferences of advanced ovarian cancer patients for adding bevacizumab to first-line therapy.

Gynecol Oncol. 2016-12

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