Maung Hein, Gregory Oliver, De Hoog Thomas, Hutchinson Matthew, Soh Dr Pith Beh, Marino Matthew, Evans Tobias, Yeoh Adrian, Turner Richard C
Faculty of Medicine University of Tasmania, Tasmania, Australia.
General Surgical Department, Royal Hobart Hospital, Tasmania, Australia.
Surg Pract Sci. 2024 Jul 4;19:100254. doi: 10.1016/j.sipas.2024.100254. eCollection 2024 Dec.
Medullary carcinoma of the colon is a rare subtype of adenocarcinoma, first described in 1999. Clinically known to have a favourable prognosis in comparison to poorly differentiated cancers, it is associated with deficient mismatch repair. This is an observational single center study of patients with medullary cancer, and comparison with the current literature.
We performed a search of the pathological database at our institution for medullary adenocarcinomas between the years of 2016-2023 and reviewed their clinical information to collect all relevant data including patient history, hospital admissions. surgery and clinic visits. We then performed a literature search using Pubmed for search terms medullary cancer/carcinoma of the colon/colorectum.
11 patients were found in our database, 34 studies in the literature, 19 retrospective cohort studies (3144 patients) and 13 case reports. 81.8% (vs. 73.22% in cohort studies) were female patients. 8/11 patients' tumours had lympho-vascular invasion with 2/11 perineural involvement. Immunohistochemistry demonstrated 11/11 patients' tumours with MLH1 and PMS2 loss, and presence of MSH2 and MSH6. Cohort studies demonstrated 302/1897 (15.92%) tumours had perineural invasion with 1133/2151 (52.67%) demonstrating lympho-vascular invasion. MLH1 testing was available for 192 patients, with 93.75% having loss of MLH1.
Our cohort of medullary cancer patients were similar to that in the literature, with regards to demographics, staging and tumour characteristics. A longer follow-up time is required for our cohort to analyze long term survival outcomes.
结肠髓样癌是腺癌的一种罕见亚型，于1999年首次被描述。临床上已知其与低分化癌相比预后较好，与错配修复缺陷有关。这是一项对髓样癌患者的观察性单中心研究，并与当前文献进行比较。
我们在本机构的病理数据库中搜索2016年至2023年间的髓样腺癌，并回顾其临床信息以收集所有相关数据，包括患者病史、住院情况、手术和门诊就诊情况。然后我们使用PubMed以“髓样癌/结肠癌/结直肠癌”为检索词进行文献检索。
我们的数据库中发现了11例患者，文献中有34项研究，19项回顾性队列研究（3144例患者）和13例病例报告。81.8%（队列研究中为73.22%）为女性患者。11例患者中有8例肿瘤有淋巴血管侵犯，11例中有2例有神经周围侵犯。免疫组化显示11例患者的肿瘤均有MLH1和PMS2缺失，且存在MSH2和MSH6。队列研究显示，1897例中有302例（15.92%）肿瘤有神经周围侵犯，2151例中有1133例（52.67%）有淋巴血管侵犯。192例患者可进行MLH1检测，其中93.75%有MLH1缺失。
我们的髓样癌患者队列在人口统计学、分期和肿瘤特征方面与文献中的相似。我们的队列需要更长的随访时间来分析长期生存结果。
