Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Key Laboratory of Metabolism and Gastrointestinal Tumor, Key Laboratory of Laparoscopic Technology, Shandong Medicine and Health Key Laboratory of General Surgery, NO.16766 Jingshi Road, Jinan, 250000, Shandong, China.
Department of General Surgery, Shandong Provincial Qianfoshan Hospital, School of Clinical Medicine, Weifang Medical University, Weifang, China.
BMC Cancer. 2024 Sep 19;24(1):1161. doi: 10.1186/s12885-024-12905-3.
Many studies have explored the clinicopathological features and prognosis between colorectal mucinous adenocarcinoma (MAC) and adenocarcinoma (AC) and have given different results. This meta-analysis summarizes previous evidence and evaluates the clinicopathological and prognostic features of MAC relative to AC in colorectal cancers (CRCs).
The meta-analysis was conducted by searching the databases of PubMed, China National Knowledge Infrastructure (CNKI), WANFANG data, Embase, and Web of Science. Pooled odds ratios (ORs) and hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated to assess the clinicopathological and prognostic differences between MAC and AC.
Fifty-six studies involving 803157 patients met the inclusion criteria and were included in this meta-analysis. The clinicopathological features of MAC were greatly different from AC, except for lymphatic invasion (OR = 1.07, 95% CI: 0.99-1.15, P = 0.09) and perineural invasion (OR = 0.92, 95% CI: 0.79-1.06, P = 0.09). Further investigation found that MAC predicted poor OS (HR = 1.04, 95% CI: 1.03-1.04, P < 0.01), but not DFS in CRCs (HR = 1.01,95% CI: 0.88- 1.17, P = 0.85). Subgroup analysis found that MAC was obviously correlated with OS in patients with different recruitment time, with tumor located in rectum, from different regions, with different sample sizes and with TNM stage in II, and calculated by different data types(P < 0.01).
This study shows that MAC displays obviously different clinicopathological features compared with AC. And MAC has a poor OS relative to AC but the DFS was comparable.
许多研究已经探讨了结直肠黏液腺癌(MAC)和腺癌(AC)的临床病理特征和预后,并得出了不同的结果。本荟萃分析总结了以往的证据,并评估了 MAC 相对于结直肠癌(CRC)中 AC 的临床病理和预后特征。
通过检索 PubMed、中国知网(CNKI)、万方数据、Embase 和 Web of Science 数据库进行荟萃分析。计算合并优势比(ORs)和风险比(HRs)及其相应的 95%置信区间(CIs),以评估 MAC 和 AC 之间的临床病理和预后差异。
共有 56 项研究纳入了 803157 名患者,符合纳入标准并纳入本荟萃分析。MAC 的临床病理特征与 AC 有很大的不同,除了淋巴血管侵犯(OR=1.07,95%CI:0.99-1.15,P=0.09)和神经周围侵犯(OR=0.92,95%CI:0.79-1.06,P=0.09)。进一步研究发现,MAC 预测 CRC 患者的总生存期(OS)较差(HR=1.04,95%CI:1.03-1.04,P<0.01),但无病生存期(DFS)无差异(HR=1.01,95%CI:0.88-1.17,P=0.85)。亚组分析发现,MAC 与不同招募时间、肿瘤位于直肠、不同地区、不同样本量、不同 TNM 分期以及不同数据类型的患者的 OS 明显相关(P<0.01)。
本研究表明,MAC 与 AC 相比表现出明显不同的临床病理特征。MAC 相对于 AC 有较差的 OS,但 DFS 相当。