Green J B, Timmcke A E, Mitchell W T, Hicks T C, Gathright J B, Ray J E
Department of Colon and Rectal Surgery, Ochsner Clinic, New Orleans, Louisiana 70121.
Dis Colon Rectum. 1993 Jan;36(1):49-54. doi: 10.1007/BF02050301.
The significance of mucinous carcinoma has been controversial since first described by Parham in 1923. Previous reports have suggested that mucinous tumors affect young patients, involve the more proximal colon, are more advanced at diagnosis, and have a poorer prognosis than nonmucinous colon carcinoma. More recent reports have refuted these results. In an effort to clarify the significance of mucinous histology, a retrospective review of cases of invasive colon cancer treated at the Ochsner Clinic between 1982 and 1985 was undertaken. Mucinous adenocarcinoma, as defined by > or = 50 percent mucin, was found in 52 patients. During the same period, 343 nonmucinous adenocarcinomas were resected. The mean age, distribution within the colon, stage at diagnosis, and survival of mucinous carcinoma patients were compared with those with nonmucinous tumors. Mucinous tumors presented at a statistically significant more advanced stage (38 percent vs. 22 percent Dukes C lesions; P < 0.01). No significant differences were seen in age at presentation, distribution within the colon, or stage-for-stage survival when the entire group was analyzed. Mucinous carcinomas of the rectum occurred at an advanced stage more frequently (P < 0.05) than nonmucinous rectal carcinomas and had a markedly worse five-year survival (11 percent vs. 57 percent; P < 0.002).
自1923年帕勒姆首次描述黏液腺癌以来，其意义一直存在争议。既往报告表明，黏液性肿瘤影响年轻患者，累及近端结肠，诊断时病情更严重，预后比非黏液性结肠癌更差。最近的报告反驳了这些结果。为了阐明黏液性组织学的意义，对1982年至1985年在奥施纳诊所接受治疗的浸润性结肠癌病例进行了回顾性研究。52例患者被诊断为黏液腺癌（定义为黏液含量≥50%）。同期，343例非黏液腺癌患者接受了手术切除。将黏液腺癌患者与非黏液性肿瘤患者的平均年龄、在结肠内的分布、诊断时的分期及生存率进行了比较。黏液性肿瘤在统计学上表现为更晚期（38%对22%的杜克C期病变；P<0.01）。对整个研究组进行分析时，在发病年龄、在结肠内的分布或各期生存率方面未发现显著差异。直肠黏液腺癌比非黏液性直肠癌更常处于晚期（P<0.05），且五年生存率明显更低（11%对57%；P<0.002）。
