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. 2008 May;15(5):1429-39.
doi: 10.1245/s10434-007-9757-1. Epub 2008 Feb 27.

Two subtypes of mucinous adenocarcinoma of the colorectum: clinicopathological and genetic features

Sarli Leopoldo  1 , Bottarelli Lorena, Azzoni Cinzia, Di Cola Gabriella, Barilli Angela Luciana, Costi Renato, Mazzeo Antonio, Salvemini Carlo, Porrini Cristina, Cecchini Stefano, Taglia Maurizio, Roncoroni Luigi, Bordi Cesare
Affiliations

Two subtypes of mucinous adenocarcinoma of the colorectum: clinicopathological and genetic features

Sarli Leopoldo et al. Ann Surg Oncol. 2008 May.

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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