Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road of Erqi District, Zhengzhou, 450052, China.
Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Sci Rep. 2024 Aug 12;14(1):18682. doi: 10.1038/s41598-024-69916-0.
Mucinous adenocarcinoma (MAC) is a distinct subtype of colorectal cancer. Previous studies have confirmed the poor prognosis of rectal or left-sided colon MAC, while the prognosis and response to chemotherapy in proximal colon MAC remains controversial. The aim of this study was to investigate the clinicopathological characteristics, prognosis, response to chemotherapy, and risk prediction factors of proximal colon MAC. Patients with proximal colon MAC and non-mucinous adenocarcinoma (NMAC) were retrospectively analyzed in this study. The analyzed variables included gender, age, smoking, drinking, chemotherapy, metastasis, pathological stage, and tumor size. Overall survival (OS) was the primary outcome. Kaplan-Meier analysis was used to assess the impact of mucinous subtype and chemotherapy on OS. We conducted univariate and multivariate Cox regression analyses to determine prognosis factors for proximal colon MAC and NMAC. A total of 284 cases of proximal colon MAC and 1384 cases of NMAC were included in the study. Compared to NMAC, proximal colon MAC was diagnosed at a younger age. The proportion of synchronous and metachronous metastasis was also higher, as well as the pathological stage and tumor size. Proximal colon MAC had a worse prognosis than NMAC, especially in stage 3. Moreover, the prognosis of proximal colon NMAC improved after chemotherapy, while MAC showed no improvement in prognosis after chemotherapy. Advanced age, N1 and N2 stage were independent prognostic factors for adverse outcomes in MAC. For proximal colon adenocarcinoma, the independent predictors of adverse outcomes included mucinous subtype, order age, N1 and N2 stages, and pathological stage 4. Proximal colon MAC had a worse prognosis compared to NMAC. Chemotherapy did not improve the prognosis of proximal colon mucinous adenocarcinoma.
黏液腺癌（MAC）是结直肠癌的一个独特亚型。先前的研究已经证实了直肠或左侧结肠癌 MAC 的预后不良，而近端结肠癌 MAC 的预后和对化疗的反应仍存在争议。本研究旨在探讨近端结肠癌 MAC 的临床病理特征、预后、对化疗的反应和风险预测因素。本研究回顾性分析了近端结肠癌 MAC 和非黏液性腺癌（NMAC）患者。分析的变量包括性别、年龄、吸烟、饮酒、化疗、转移、病理分期和肿瘤大小。总生存期（OS）是主要结局。采用 Kaplan-Meier 分析评估黏液型和化疗对 OS 的影响。我们进行了单因素和多因素 Cox 回归分析，以确定近端结肠癌 MAC 和 NMAC 的预后因素。共纳入 284 例近端结肠癌 MAC 和 1384 例 NMAC 患者。与 NMAC 相比，近端结肠癌 MAC 的诊断年龄较小。同时性和异时性转移的比例也较高，病理分期和肿瘤大小也较大。与 NMAC 相比，近端结肠癌 MAC 的预后较差，尤其是在 3 期。此外，化疗后近端结肠癌 NMAC 的预后有所改善，而 MAC 化疗后预后无改善。高龄、N1 和 N2 期是 MAC 不良预后的独立预后因素。对于近端结肠癌，不良预后的独立预测因素包括黏液型、高龄、N1 和 N2 期以及病理 4 期。与 NMAC 相比，近端结肠癌 MAC 的预后较差。化疗不能改善近端结肠癌黏液性腺癌的预后。
