1. Clinicopathological and genetic differences between low-grade and high-grade colorectal mucinous adenocarcinomas.
- Author
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Yoshioka, Yasumasa, Togashi, Yosuke, Chikugo, Takaaki, Kogita, Akihiro, Taguri, Masataka, Terashima, Masato, Mizukami, Takuro, Hayashi, Hidetoshi, Sakai, Kazuko, de Velasco, Marco A., Tomida, Shuta, Fujita, Yoshihiko, Tokoro, Tadao, Ito, Akihiko, Okuno, Kiyotaka, and Nishio, Kazuto
- Subjects
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COLON cancer , *MUCINOUS adenocarcinoma , *GENETIC mutation , *ADENOMATOUS polyposis coli , *NUCLEOTIDE sequencing , *PROTEIN metabolism , *CARRIER proteins , *COLON tumors , *POLYMERASE chain reaction , *PROGNOSIS , *PROTEINS , *TUMORS , *DNA-binding proteins , *RETROSPECTIVE studies , *NUCLEAR proteins , *SEQUENCE analysis , *TUMOR grading ,RECTUM tumors - Abstract
Background: Although colorectal mucinous adenocarcinomas (MCs) are conventionally regarded as exhibiting high-grade differentiation, they can be divided by differentiation into 2 groups according to the glandular appearance: low-grade mucinous adenocarcinoma (low-MC) and high-grade mucinous adenocarcinoma (high-MC).Methods: Patients with colorectal cancer (CRC) who underwent surgical resection between 2000 and 2012 were enrolled in this study. Among the cases with MC, the clinicopathological and genetic differences between low-MC and high-MC were investigated with next-generation sequencing.Results: A total of 1373 patients with CRC were analyzed. Forty patients (2.9%) had MC, and 13 patients had high-MC. Patients with MC had significantly shorter disease-free survival (DFS) and overall survival (OS) periods than those with nonmucinous carcinoma. When low-MC patients and high-MC patients were compared, those with high-MC had significantly shorter DFS and OS periods than those with low-MC. Multivariate analyses revealed that high-MC was significantly associated with both shorter DFS and shorter OS, but low-MC was not. A genome analysis revealed that low-MC had a considerably larger number of mutations than high-MC, and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations and adenomatous polyposis coli mutations were particularly frequently found in low-MC. In contrast, SMAD family member 4 (SMAD4) mutations were frequently found in high-MC.Conclusions: High-MC is an independent prognostic factor in CRC (but low-MC is not), and it is genetically different from other CRCs, including low-MC. Both the clinicopathological differences and the genetic differences suggest that low-MC and high-MC should be distinguished in clinical settings. [ABSTRACT FROM AUTHOR]- Published
- 2015
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