Zhao Li, Liu Shao-Yan, Li Yu-Meng, Xiong Zhong-Tang
Department of Pathology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510150, P.R. China.
Oncol Lett. 2021 Jan;21(1):72. doi: 10.3892/ol.2020.12333. Epub 2020 Nov 25.
Colorectal cancer (CRC) is a common malignant tumor of digestive system. CRC with micropapillary pattern (MPP) is an aggressive variant of colorectal adenocarcinoma. The aim of the present study was to clarify the clinicopathological significance and the prognostic role of an immunohistochemical marker, MPP, in CRC. The association between MPP and clinicopathological characteristics and prognosis in 286 cases of CRC (286/453 cases had follow-up information) were analysed. Then, 81 tissues without MPP and 90 tissues with MPP were analysed by immunohistochemistry using antibodies against villin, E-cadherin and epithelial membrane antigen (EMA). Bioinformatics was used to evaluate the expression of these three indicators in CRC. The proportion of micropapillary carcinoma in the overall tumour was ≥5%, and was observed in 90/453 cases (19.8%). The present data showed that CRC with MPP displayed higher rates of vascular and lymphatic invasion, a higher metastatic lymph node ratio and a higher pathological tumour and metastasis stage compared with CRC without MPP. The positive expression rates of EMA, E-cadherin and villin were 50.3, 93.4 and 96.5%, respectively. In 90 CRC cases with MPP, EMA inside-out pattern (I/OP) staining was observed in 26 cases (28.9%), and it was often focal and partial, while 37 cases (41.1%) had E-cadherin focal and partial staining compatible with reverse polarity. Villin I/OP staining was observed in 77 cases (85.6%), and circumferential staining predominated over partial staining. Overall, the data suggested that the presence of MPP is significantly associated with aggressive tumour behaviour and worse overall survival rate in CRC. Visualization and distinction of reverse polarity of colorectal micropapillary carcinomas is improved villin compared with EMA or E-cadherin.
结直肠癌（CRC）是消化系统常见的恶性肿瘤。具有微乳头模式（MPP）的结直肠癌是结直肠腺癌的一种侵袭性变体。本研究的目的是阐明免疫组化标志物MPP在结直肠癌中的临床病理意义及预后作用。分析了286例结直肠癌（286/453例有随访信息）中MPP与临床病理特征及预后的相关性。然后，使用抗绒毛蛋白、E-钙黏蛋白和上皮膜抗原（EMA）的抗体，通过免疫组化分析81例无MPP的组织和90例有MPP的组织。利用生物信息学评估这三种指标在结直肠癌中的表达。微乳头癌在总体肿瘤中的比例≥5%，在90/453例（19.8%）中观察到。目前的数据表明，与无MPP的结直肠癌相比，有MPP的结直肠癌表现出更高的血管和淋巴管侵犯率、更高的转移淋巴结比例以及更高的病理肿瘤和转移分期。EMA、E-钙黏蛋白和绒毛蛋白的阳性表达率分别为50.3%、93.4%和96.5%。在90例有MPP的结直肠癌病例中，26例（28.9%）观察到EMA由内向外模式（I/OP）染色，且通常为局灶性和部分性，而37例（41.1%）有与极性反转相符的E-钙黏蛋白局灶性和部分性染色。77例（85.6%）观察到绒毛蛋白I/OP染色，且环形染色多于部分性染色。总体而言，数据表明MPP的存在与结直肠癌的侵袭性肿瘤行为和更差的总生存率显著相关。与EMA或E-钙黏蛋白相比，绒毛蛋白能更好地实现结直肠微乳头癌极性反转的可视化和区分。
