Department of Experimental Research, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
BMC Cancer. 2019 Nov 8;19(1):1071. doi: 10.1186/s12885-019-6245-5.
Although numerous studies have investigated the clinicopathologic and prognostic relevance of mucinous adenocarcinoma (MAC) and signet-ring cell carcinoma (SRCC) compared with classic adenocarcinoma (CA), little is known about the prognosis of adenocarcinoma with mixed subtypes (AM) and the differences among these four subtypes.
The statistics of colorectal cancer registered in the Surveillance, Epidemiology and End Results (SEER) database were retrieved and analyzed. We also compared the clinicopathologic and prognostic relevance between CA, SRCC, MAC, and AM.
The frequencies of these four subtypes were 69.9% (CA, n = 15,812), 25.1% (MAC, n = 5689), 3.6% (SRCC, n = 814) and 1.4% (AM, n = 321), respectively. All of MAC, SRCC, and AM were significantly related with aggressive features. Only SRCC and AM were identified as independent poor prognostic markers for overall survival by multivariate analysis. The aggressiveness of AM was between MAC and SRCC according to the clinicopathologic associations. The prognosis of AM was significantly worse than MAC but comparable with SRCC.
We confirmed the clinicopathologic relevance with aggressive features of MAC and SRCC, as well as poor prognostic relevance of SRCC by analyzing a large study population data set. Furthermore, we identified AM as a rare but aggressive histologic subtype in colorectal cancer, to which particular attention should be given in clinical practice.
尽管已有大量研究比较了黏液性腺癌（MAC）和印戒细胞癌（SRCC）与经典腺癌（CA）的临床病理和预后相关性，但对于混合亚型腺癌（AM）的预后以及这四种亚型之间的差异知之甚少。
检索并分析了美国监测、流行病学和最终结果（SEER）数据库中登记的结直肠癌统计数据。我们还比较了 CA、SRCC、MAC 和 AM 之间的临床病理和预后相关性。
这四种亚型的频率分别为 69.9%（CA，n=15812）、25.1%（MAC，n=5689）、3.6%（SRCC，n=814）和 1.4%（AM，n=321）。MAC、SRCC 和 AM 均与侵袭性特征显著相关。仅 SRCC 和 AM 被多变量分析确定为总生存的独立不良预后标志物。根据临床病理相关性，AM 的侵袭性介于 MAC 和 SRCC 之间。AM 的预后明显比 MAC 差，但与 SRCC 相当。
我们通过分析大型研究人群数据集，证实了 MAC 和 SRCC 具有侵袭性特征以及 SRCC 具有不良预后相关性的临床病理相关性。此外，我们发现 AM 是结直肠癌中一种罕见但侵袭性的组织学亚型，在临床实践中应特别注意。
