Influence of mucinous components on survival in colorectal adenocarcinomas: a multivariate analysis.

Halvorsen, Tore; Seim, E

doi:10.1136/jcp.41.10.1068

Cited by 93 publications

(69 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some studies found colorectal mucinous adenocarcinoma to be an independent prognostic factor for poor outcomes, 10,11 whereas other studies found that poor outcomes seen for mucinous adenocarcinoma are more related to tumor stage or specific tumor location (eg, rectum), suggesting that this histologic subtype is not an independent adverse prognostic factor. 5,9,12,13 Signet-ring cell carcinomas usually have some extracellular mucin production. Occasionally, mucin accumulates intracellularly in mucinous adenocarcinomas, resulting in signet-ring cell morphology.…”

mentioning

confidence: 99%

Clinical significance of signet-ring cells in colorectal mucinous adenocarcinoma

et al. 2008

View full text Add to dashboard Cite

Mucin occasionally accumulates intracellularly in colorectal mucinous adenocarcinomas, resulting in signetring cell morphology. In the current practice of pathology, there is no definitive rule on how to report a minor component of signet-ring cells in colorectal mucinous adenocarcinomas. We hypothesized that the absence of signet-ring cell component might have a favorable effect on survival of mucinous adenocarcinoma patients. To assess the biological characteristics of colorectal mucinous adenocarcinoma, we analyzed its clinicopathological features, microsatellite instability status, and survival outcomes and compared them with those of colorectal signet-ring cell carcinoma. A total of 266 consecutive colorectal mucinous adenocarcinoma patients and 65 signet-ring cell carcinoma patients were included. Mucinous adenocarcinomas, by comparison with signet-ring cell carcinomas, were characterized by development at an older age, less frequent vascular invasion and lymph node metastasis, and lower TNM stage at presentation. A total of 21 (22%) of 95 mucinous adenocarcinomas and 12 (19%) of 63 signet-ring cell carcinomas were high-frequency microsatellite instability. Patients with mucinous adenocarcinoma had significantly better survival than those with signet-ring cell carcinoma (Po0.0001) or than those with signet-ring cell carcinoma showing 450% extracellular mucin by volume (Po0.0001). In univariate analysis, absence of signet-ring cell component (P ¼ 0.0197), absence of vascular invasion, decreased invasion depth, no lymph node metastasis, and lower TNM stage had a favorable effect on survival of mucinous adenocarcinoma patients. Absence of vascular invasion, no lymph node metastasis, and lower TNM stage had a favorable effect on survival of signet-ring cell carcinoma patients. Multivariate analysis showed that higher TNM stage and T stage 4 were independent predictors of poor outcome in patients with mucinous adenocarcinoma. Our observations strongly suggest that pathologists should report the percentage of signet-ring cell component in colorectal mucinous adenocarcinomas and mucinous adenocarcinoma has different biologic behavior compared with signet-ring cell carcinoma. Modern Pathology (2008Pathology ( ) 21, 1533Pathology ( -1541 doi:10.1038/modpathol.2008 published online 10 October 2008 Keywords: colorectal mucinous adenocarcinoma; signet-ring cell; survival Although colorectal adenocarcinoma has a relatively better prognosis than other gastrointestinal malignancies with the same stage, specific histological types of colorectal carcinoma such as mucinous adenocarcinoma and signet-ring cell carcinoma have a poor prognosis. 1-3 Colorectal mucinous adenocarcinoma and signet-ring cell carcinoma are adenocarcinomas in which the cancer cells produce excess mucin. A unique pathologic feature of signet-ring cell carcinoma is the presence of signetring cells, which are single tumor cells with intracytoplasmic mucin that displaces their nuclei. The infiltrating cells spread diffusely throughout the bowel wall. I...

show abstract

mentioning

confidence: 99%

Clinical significance of signet-ring cells in colorectal mucinous adenocarcinoma

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Whether the mucinous phenotype is associated with relatively poor prognosis is a matter of controversy; more recent multivariate analyses of the course of the disease in a large number of patients indicate that the mucinous carcinomas of the colorectum do not differ in their clinical behaviour from non-mucinous (Sasaki et al, 1987;Halvorsen and Seim, 1988;Hermanek et al, 1989) or signet ring cell carcinomas (Sasaki et al, 1987). The pattern of the genetic lesions in mucinous carcinomas is, however, different from that in non-mucinous ones.…”

mentioning

confidence: 99%

Is mucinous carcinoma of the colorectum a distinct genetic entity?

Hanski

1995

Br J Cancer

View full text Add to dashboard Cite

Summary Mucinous carcinomas are defined on the basis of the amount of the mucus component in the tumour mass. Apart from this quantitative criterion, a number of clinicopathological parameters (such as localisation, prevalence in different countries and age groups, association with HNPCC and inflammatory processes) and genetic alterations (e.g. frequency of mutation in Ki-ras and p53 genes, level of MUC2 expression) differentiate these tumours from the non-mucinous ones. Since a different set of genetic lesions implies different inducing agents, these observations suggest that there may be a 'mucinous pathway of carcinogenesis'. Further identification of genetic changes characteristic of the mucinous phenotype will help to understand the aetiology of these tumours and possibly establish markers for detection of the high-risk group.Keywords: mucinous carcinoma; p53; MUC2; aetiology The designation mucinous carcinomas is applied to colorectal tumours in which mucus secretion largely contributes to the tumour growth. Different authors classified colonic tumours as mucinous when the mucin lakes represented 50% (Pihl et al., 1980) to 80% (Umpleby et al., 1985) of the tissue; the definition set by World Health Organization and applied in the more recent reports and in the present minireview requires the mucinous component to represent more than 50% of the tumour (Jass and Sobin, 1990).Whether the mucinous phenotype is associated with relatively poor prognosis is a matter of controversy; more recent multivariate analyses of the course of the disease in a large number of patients indicate that the mucinous carcinomas of the colorectum do not differ in their clinical behaviour from non-mucinous (Sasaki et al., 1987;Halvorsen and Seim, 1988; Hermanek et al., 1989) or signet ring cell carcinomas (Sasaki et al., 1987). The pattern of the genetic lesions in mucinous carcinomas is, however, different from that in non-mucinous ones. Some of these differences are obviously related to the mucinous phenotype (like the level of MUC2 expression) and may be epiphenomenal, while others (such as activation of proto-oncogenes and inactivation of suppressor genes) belong to the group of lesions assumed to be fundamental in carcinogenesis. The present analysis of the recently defined genetic differences as well as indicators of inherent genetic differences between the mucinous and nonmucinous phenotype suggests that distinct molecular lesions occur during the development of these two types of colorectal carcinoma. Clinicopathological parametersSimilar prevalence in the left and the right colon Several studies indicate that 19-40% of non-mucinous sporadic carcinomas are located in the right colon while the majority is found in the left colon (Symonds and Vickery, 1976;Umpleby et al., 1985;Milne, 1994). By contrast, the prevalence of mucinous carcinomas is approximately equal in both segments (Symonds and Vickery, 1976; Sundblad and Paz, 1982;Umpleby et al., 1985). For example, in a recent study of 80 mucinous carcinomas 46% were loca...

show abstract

“…A variabilidade dos comportamentos clínico e biológico do CCR tem suscitado grande interesse pelo estudo de fatores que possam estar associados à progressão da neoplasia e, conseqüentemente, ao prog- nóstico da doença 26,37 . O diagnóstico precoce 38 a idade 7 localização da neoplasia 44 , graduação histológica 15 ,grau de penetração na parede intestinal 11 , comprometimento linfonodal 2 produção de muco pela neoplasia 16 antígeno carcinoembrinonário (CEA) 25 , invasão venosa e neuronal 22 são as variáveis mais frequentemente estudadas, como fatores relacionados ao prognóstico do CCR. Estudos foram realizados com o intuito de discriminar o poder prognóstico independente das principais variáveis relacionadas ao CCR 23 35 .…”

Section: Introductionunclassified

Polimorfismos das isoformas M1, T1 e P1 da glutationa S-transferase e associação com os aspectos clínico-patológicas no carcinoma colorretal

Ansolin

Damin

Alexandre

2010

Rev bras. colo-proctol.

View full text Add to dashboard Cite

RESUMO: As variáveis clínico-patológicas são importantes fatores que possam estar associados à progressão da neoplasia e, conseqüentemente, ao prognóstico da doença. As glutationas S-Transferases GSTM1, GSTT1 e GSTP1 são enzimas da segunda fase de biotransformação que atuam na destoxificação de uma ampla variedade de agentes exógenos incluindo os carcinógenos. Os genes GSTM1 , GSTT1 e GSTP1 são polimórficos em humanos e suas variantes têm sido associadas, em algumas populações, ao aumento dos riscos de neoplasia, entre elas o carcinoma colorretal. Neste estudo retrospectivo 50 biópsias de pacientes com carcinoma colorretal do Rio Grande do Sul foram analisadas os polimorfismos nos genes GSTM1 , GSTT1 e GSTP1 por PCR multiplex e RFLP, quanto às variáveis clínico-patológicas: localização, estadiamento e diferenciação. Não foram encontrados valores p significativo nas variáveis: estadiamento (p=0,28, p=0,93 e p=0,67), diferenciação (p=0,70 e p=0,37) e localização (p= 0,23. p= 0,58 e p= 0,60 ) respectivamente e o presença do polimorfismos dos genes GSTM1, GSTT1 e GSTP1 nas variáveis estadiamento e localização. A única variável clínico-patológica que apresentou valor significativo na diferenciação do CCR foi o polimorfismo do gene GSTP1 Ile/val e val/val (p= 0,046) entretanto, mais pesquisas são necessárias para confirmar estes achados ,visto que, esses resultados podem ter sido influenciados pelo número reduzido de biópsias analisadas.Descritores: GSTs, Câncer colorretal, Aspectos clínico-patológicos. Trabalho realizado no Laboratório de Biologia Molecular da Pós-Graduação da Universidade Federal de Ciências da Saúde de Porto

show abstract

Influence of mucinous components on survival in colorectal adenocarcinomas: a multivariate analysis.

Cited by 93 publications

References 11 publications

Clinical significance of signet-ring cells in colorectal mucinous adenocarcinoma

Clinical significance of signet-ring cells in colorectal mucinous adenocarcinoma

Is mucinous carcinoma of the colorectum a distinct genetic entity?

Polimorfismos das isoformas M1, T1 e P1 da glutationa S-transferase e associação com os aspectos clínico-patológicas no carcinoma colorretal

Contact Info

Product

Resources

About