Mucinous colorectal adenocarcinoma: clinical pathology and treatment options
Tóm tắt
Mucinous colorectal adenocarcinoma is a distinct subtype of colorectal cancer (CRC) characterized by the presence of abundant extracellular mucin which accounts for at least 50% of the tumor volume. Mucinous colorectal adenocarcinoma is found in 10%–20% of CRC patients and occurs more commonly in female and younger patients. Moreover, mucinous colorectal adenocarcinoma is more frequently located in the proximal colon and diagnosed at an advanced stage. Based on its molecular context, mucinous colorectal adenocarcinoma is associated with the overexpression of mucin 2 (MUC2) and mucin 5AC (MUC5AC) proteins. At the same time, it shows higher mutation rates in the fundamental genes of the RAS/MAPK and PI3K/Akt/mTOR pathways. Mucinous colorectal adenocarcinoma also shows higher rates of microsatellite instability (MSI) than non‐mucinous colorectal adenocarcinoma which might correlate it with Lynch syndrome and the CpG island methylator phenotype. The prognosis of mucinous colorectal adenocarcinoma as to non‐mucinous colorectal adenocarcinoma is debatable. Further, the impaired responses of mucinous colorectal adenocarcinoma to palliative or adjuvant chemotherapy warrant more studies to be performed for a specialized treatment for these patients. In this review, we discuss the molecular background and histopathology of mucinous colorectal adenocarcinoma, and provide an update on its prognosis and therapeutics from recent literatures.
Từ khóa
Tài liệu tham khảo
Bosman FT, 2010, WHO classification of tumours of the digestive system
Okuno M, 1988, Mucinous colorectal carcinoma: clinical pathology and prognosis, Am Surg., 54, 681
Gruia C, 2011, Synchronous carcinoma of the ascending colon and caecum, Rom J Morphol Embryol, 52, 1369
NumataM ShiozawaM WatanabeT TamagawaH YamamotoN MorinagaS et al.The clinicopathological features of colorectal mucinous adenocarcinoma and a therapeutic strategy for the disease.World J Surg Oncol.2012;10.1186/1477‐7819‐10‐1093407705
Takahashi Y, 1995, Expression of vascular endothelial growth factor and its receptor, KDR, correlates with vascularity, metastasis, and proliferation of human colon cancer, Can Res., 55, 3964
Berk V, 2015, Predictive significance of VEGF and HIF‐1alpha expression in patients with metastatic colorectal cancer receiving chemotherapy combinations with bevacizumab, APJCP., 16, 6149
Fu Z, 2012, mucinous adenocarcinoma of the colon pathological characters and CT image analysis, Chin J Mod Drug Appl., 04, 24
Liu Z, 2016, Comparison of FOLFOX and FOLFIRI adjuvant chemotherapy regimens in the treatment of colorectal mucinous adenocarcinoma, Chin J Colorec Dis (Electronic Edition), 5, 159
VenookAP NiedzwieckiD InnocentiF FruthB GreeneC O'NeilBH et al.Impact of primary (1 degrees) tumor location on overall survival (OS) and progression‐free survival (PFS) in patients (pts) with metastatic colorectal cancer (mCRC): analysis of CALGB/SWOG 80405 (Alliance).J Clin Oncol.2016;10.1200/jco.2016.34.15_suppl.35045012711
Liu H, 2015, Addition of bevacizumab to neoadjuvant chemotherapy for stage IV ovarian serous adenocarcinoma with multiple lymph node metastases: a case report, Eur J Gynaecol Oncol., 36, 341
Loftsson T, 2012, Drug permeation through biomembranes: cyclodextrins and the unstirred water layer, Pharmazie, 67, 363