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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2008

01-05-2008 | Gastrointestinal Oncology

Two Subtypes of Mucinous Adenocarcinoma of The Colorectum: Clinicopathological and Genetic Features

Authors: Sarli Leopoldo, MD, Bottarelli Lorena, BScD, Azzoni Cinzia, BScD, Di Cola Gabriella, BScD, PhD, Barilli Angela Luciana, MathD, Costi Renato, MD, PhD, Mazzeo Antonio, MD, Salvemini Carlo, MD, Porrini Cristina, MD, Cecchini Stefano, MD, Taglia Maurizio, MD, Roncoroni Luigi, MD, Bordi Cesare, MD

Published in: Annals of Surgical Oncology | Issue 5/2008

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Abstract

Background

This work is aimed at comparing mucinous colorectal adenocarcinomas (MUC) and non-mucinous colorectal adenocarcinomas (non-MUC), and at verifying the existence of two different subgroups of MUC, in terms of clinicopathological features, chromosomal alterations, and outcome, in a geographical area where mucinous colorectal cancer resulted as being very frequent.

Methods

One hundred and fifty-six unselected patients who underwent curative colorectal resection for sporadic colorectal cancer over a 4-year period were evaluated for histological classification as to MUC and non-MUC subtype, for microsatellite instability (MSI) using six microsatellite markers, and for the presence of p27, Fhit, and cyclooxygenase-2 (Cox-2). Molecular data, immunohistochemical results, recurrence frequency, and patient survival were analyzed statistically in relation to histological subtypes.

Results

MUC accounted for 38.5% of all colorectal carcinomas. Compared to non-MUCs, MUCs were more frequently located in the proximal colon (p < 0.001), and more frequently showed MSI phenotype (p < 0.001), altered protein expression of hMlh1 (p = 0.030), Fhit (p <0.001), and p27 (p < 0.001). Compared to MUC with microsatellite-stable (MSS) phenotype, MUC with MSI more frequently resulted as being located in the proximal colon (p = 0.013), and more frequently showed altered expression of hMlh1 (p < 0.001), hMsh2 (p = 0.008), Fhit (p < 0.001), and p27 (p = 0.015). Significantly better survival of patients with proximal MUC (p = 0,012), with MSI MUC (p = 0.017), and with MUC with altered p27 expression (p = 0.02).

Conclusion

The results of the present study confirm that MUC represents distinct clinicopathological and genetic features as compared to non-mucinous tumors and support the hypothesis that MUC includes two subtypes with different genetic pathways and behavior.
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Metadata
Title
Two Subtypes of Mucinous Adenocarcinoma of The Colorectum: Clinicopathological and Genetic Features
Authors
Sarli Leopoldo, MD
Bottarelli Lorena, BScD
Azzoni Cinzia, BScD
Di Cola Gabriella, BScD, PhD
Barilli Angela Luciana, MathD
Costi Renato, MD, PhD
Mazzeo Antonio, MD
Salvemini Carlo, MD
Porrini Cristina, MD
Cecchini Stefano, MD
Taglia Maurizio, MD
Roncoroni Luigi, MD
Bordi Cesare, MD
Publication date
01-05-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 5/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-007-9757-1

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