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Clinicopathological and genetic differences between low-grade and high-grade colorectal mucinous adenocarcinomas.

Clinicopathological and genetic differences between low-grade and high-grade colorectal mucinous adenocarcinomas.

Authors :
Yoshioka Y
Togashi Y
Chikugo T
Kogita A
Taguri M
Terashima M
Mizukami T
Hayashi H
Sakai K
de Velasco MA
Tomida S
Fujita Y
Tokoro T
Ito A
Okuno K
Nishio K
Source :
Cancer [Cancer] 2015 Dec 15; Vol. 121 (24), pp. 4359-68. Date of Electronic Publication: 2015 Oct 21.
Publication Year :
2015

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).<br />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.<br />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.<br />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.<br /> (© 2015 American Cancer Society.)

Details

Language :
English
ISSN :
1097-0142
Volume :
121
Issue :
24
Database :
MEDLINE
Journal :
Cancer
Publication Type :
Academic Journal
Accession number :
26488212
Full Text :
https://doi.org/10.1002/cncr.29676