结直肠黏液腺癌的免疫表型特征和预后与解剖部位有关。
Immunophenotypic profiles and prognosis for colorectal mucinous adenocarcinomas are dependent on anatomic location.
机构信息
Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA.
出版信息
Cancer Med. 2023 Apr;12(8):9637-9643. doi: 10.1002/cam4.5803. Epub 2023 Mar 14.
BACKGROUND
The prognostic value of mucinous adenocarcinomas (MCAs, exhibiting >50% extracellular mucin) of the colorectum, in relation to their anatomic location is not well studied.
MATERIALS AND METHODS
We compared MCAs (n = 175) with non-MCAs (NMCAs, n = 1015) and the cancer-specific survival rates were evaluated, based on their anatomic site, by univariate Kaplan-Meier and multivariate Cox methods. Subsets of these tumors were immunostained for MUC1, MUC2, Bcl-2, and p53.
RESULTS
MCAs were more commonly found in the right colon, were of high-grade, and were more prevalent in younger patients (<40 years). They exhibited strong expression of MUC2 and Bcl-2 and showed less p53 nuclear staining. In contrast, most NMCAs were low-grade with high expression of MUC1. MCAs of the rectum were associated with poorer outcomes relative to NMCAs (HR 1.85, CI 95% 1.15-2.97), even though the distributions of advanced-stage tumors were similar.
CONCLUSION
Late-stage disease and age were poor independent prognostic indicators of cancer-specific deaths across all tumor locations. In summary, rectal MCAs have a poor prognosis.
背景
结直肠黏液腺癌（MCAs，表现为>50%的细胞外黏液）的预后价值与其解剖位置有关，但尚未得到充分研究。
材料与方法
我们比较了 MCAs（n=175）与非 MCAs（NMCAs，n=1015），并根据解剖部位，通过单变量 Kaplan-Meier 和多变量 Cox 方法评估了这些肿瘤的癌症特异性生存率。这些肿瘤的亚组被免疫染色用于 MUC1、MUC2、Bcl-2 和 p53。
结果
MCAs 更常见于右半结肠，为高级别，且更常见于年轻患者（<40 岁）。它们强烈表达 MUC2 和 Bcl-2，p53 核染色较少。相比之下，大多数 NMCAs 为低级别，MUC1 表达较高。与 NMCAs 相比，直肠 MCAs的预后较差（HR 1.85，CI 95% 1.15-2.97），尽管晚期肿瘤的分布相似。
结论
晚期疾病和年龄是所有肿瘤部位癌症特异性死亡的独立不良预后指标。总之，直肠 MCAs 的预后较差。
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