Lan Yuan-Tzu, Chang Shih-Ching, Lin Pei-Ching, Lin Chun-Chi, Lin Hung-Hsin, Huang Shen-Chieh, Lin Chien-Hsing, Liang Wen-Yi, Chen Wei-Shone, Jiang Jeng-Kai, Lin Jen-Kou, Yang Shung-Haur
Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Front Oncol. 2021 Mar 2;11:620146. doi: 10.3389/fonc.2021.620146. eCollection 2021.
The prognosis of mucinous adenocarcinoma (MAC) and non-mucinous adenocarcinoma (NMAC) in colorectal cancer (CRC) is controversial, and the molecular differences between them are unclear.
Between 2000 and 2010, a total of 1,483 CRC patients were included. Among them, 73 patients (4.9%) were diagnosed with MAC. The clinicopathological features and genetic alterations were compared between MAC and NMAC.
After propensity score matching to balance age and sex between MAC and NMAC patients, 292 CRC patients (73 MAC and 219 NMAC) were enrolled in the analysis at a 1:3 ratio. In right-sided colon cancer, patients with MAC were more likely to have Borrmann types 3 and 4 tumors, poor differentiation, and advanced T category and tumor, node, metastasis (TNM) stage, chemotherapy, and a similar 5-year overall survival (OS) rate compared with patients with NMAC. In left-sided colon cancer and rectal cancer, patients with MAC were more likely to have Borrmann types 3 and 4 tumors, poor differentiation, lymphovascular invasion, advanced T and N categories and TNM stages, chemotherapy, and a worse 5-year OS rate than patients with NMAC. Regarding genetic alterations, for NMAC, right-sided colon cancer had more mutations than left-sided colon cancer and rectal cancer. For MAC, right-sided colon cancer was associated with more microsatellite instability-high tumors and more mutations than left-sided colon cancer and rectal cancer.
The genetic alterations are distinct between MAC and NMAC in CRC. Tumor location may have an impact on genetic alterations and patient prognosis in MAC and NMAC.
结直肠癌（CRC）中黏液腺癌（MAC）和非黏液腺癌（NMAC）的预后存在争议，且二者之间的分子差异尚不清楚。
2000年至2010年期间，共纳入1483例CRC患者。其中，73例患者（4.9%）被诊断为MAC。比较了MAC和NMAC之间的临床病理特征和基因改变。
在对MAC和NMAC患者的年龄和性别进行倾向评分匹配以达到平衡后，按1:3的比例纳入292例CRC患者（73例MAC和219例NMAC）进行分析。在右半结肠癌中，与NMAC患者相比，MAC患者更易出现Borrmann 3型和4型肿瘤、低分化、T分期高级别以及肿瘤、淋巴结、转移（TNM）分期高级别、接受化疗，且5年总生存率（OS）相似。在左半结肠癌和直肠癌中，与NMAC患者相比，MAC患者更易出现Borrmann 3型和4型肿瘤、低分化、淋巴管浸润、T和N分期高级别以及TNM分期高级别、接受化疗，且5年OS率更差。关于基因改变，对于NMAC，右半结肠癌的突变比左半结肠癌和直肠癌更多。对于MAC，右半结肠癌与微卫星高度不稳定肿瘤更多以及突变比左半结肠癌和直肠癌更多相关。
CRC中MAC和NMAC的基因改变不同。肿瘤位置可能对MAC和NMAC的基因改变及患者预后产生影响。
