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. 2023 Apr;12(8):9637-9643.
doi: 10.1002/cam4.5803. Epub 2023 Mar 14.

Immunophenotypic profiles and prognosis for colorectal mucinous adenocarcinomas are dependent on anatomic location

Chirag Patel  1 , Michael Behring  1 , Sameer Al Diffalha  1   2 , Deepti Dhall  1   2 , Goo Lee  1 , Chandrakumar Shanmugam  3 , William E Grizzle  1   2 , Upender Manne  1   2
Affiliations

Immunophenotypic profiles and prognosis for colorectal mucinous adenocarcinomas are dependent on anatomic location

Chirag Patel et al. Cancer Med. 2023 Apr.

Abstract

Background: The prognostic value of mucinous adenocarcinomas (MCAs, exhibiting >50% extracellular mucin) of the colorectum, in relation to their anatomic location is not well studied.

Materials and methods: We compared MCAs (n = 175) with non-MCAs (NMCAs, n = 1015) and the cancer-specific survival rates were evaluated, based on their anatomic site, by univariate Kaplan-Meier and multivariate Cox methods. Subsets of these tumors were immunostained for MUC1, MUC2, Bcl-2, and p53.

Results: MCAs were more commonly found in the right colon, were of high-grade, and were more prevalent in younger patients (<40 years). They exhibited strong expression of MUC2 and Bcl-2 and showed less p53 nuclear staining. In contrast, most NMCAs were low-grade with high expression of MUC1. MCAs of the rectum were associated with poorer outcomes relative to NMCAs (HR 1.85, CI 95% 1.15-2.97), even though the distributions of advanced-stage tumors were similar.

Conclusion: Late-stage disease and age were poor independent prognostic indicators of cancer-specific deaths across all tumor locations. In summary, rectal MCAs have a poor prognosis.

Keywords: colorectal cancer; mucinous adenocarcinomas; non-mucinous adenocarcinomas; prognostic biomarker; rectal cancers; tumor location.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

FIGURE 1
FIGURE 1
MCA with abundant extracellular mucin as shown by arrow (A, H&E, 4×); NMCA, which shows conventional adenocarcinoma without prominent mucin production (B, H&E, 4×); MCAs overall showed lower expression of nuclear p53 staining (C, p53, 4×) in contrast to the NMCAs, which showed higher expression of p53 (D, p53, 4×). MCAs showed slightly lower positive expression for MUC1 (E, MUC1, 4×) in contrast to NMCAs (F, MUC1, 4×). MCAs showed consistently higher expression for MUC2 (G. MUC2, 10×) in comparison to NMCAs, which showed lower expression (H, MU2, 20×); MCAs expressed slightly higher positive expression for BCL2 (I, BCL2, 4×) as compared to NMCAs (J, BCL2, 20×).
FIGURE 2
FIGURE 2
Univariate survival analyses by mucinous/non‐mucinous histological status in (A) the complete cohort (all locations); (B) proximal tumors (14% MCAs); (C) distal tumors (11% MCAs); and (D) rectal tumors (12% MCAs).
See this image and copyright information in PMC

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