Mucinous differentiation in colorectal cancer – indicator of poor prognosis?
Cord Langner
Institute of Pathology, Medical University of Graz, Graz
Search for more papers by this authorLars Harbaum
Institute of Pathology, Medical University of Graz, Graz
Search for more papers by this authorMarion J Pollheimer
Institute of Pathology, Medical University of Graz, Graz
Search for more papers by this authorPeter Kornprat
Division of General Surgery, Department of Surgery, Medical University of Graz, Graz
Search for more papers by this authorRichard A Lindtner
Institute of Pathology, Medical University of Graz, Graz
Search for more papers by this authorAndrea Schlemmer
Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
Search for more papers by this authorMichael Vieth
Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
Search for more papers by this authorPeter Rehak
Department of Surgery, Research Unit for Biomedical Engineering and Computing, Medical University of Graz, Graz, Austria
Search for more papers by this authorCord Langner
Institute of Pathology, Medical University of Graz, Graz
Search for more papers by this authorLars Harbaum
Institute of Pathology, Medical University of Graz, Graz
Search for more papers by this authorMarion J Pollheimer
Institute of Pathology, Medical University of Graz, Graz
Search for more papers by this authorPeter Kornprat
Division of General Surgery, Department of Surgery, Medical University of Graz, Graz
Search for more papers by this authorRichard A Lindtner
Institute of Pathology, Medical University of Graz, Graz
Search for more papers by this authorAndrea Schlemmer
Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
Search for more papers by this authorMichael Vieth
Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
Search for more papers by this authorPeter Rehak
Department of Surgery, Research Unit for Biomedical Engineering and Computing, Medical University of Graz, Graz, Austria
Search for more papers by this authorAbstract
Langner C, Harbaum L, Pollheimer M J, Kornprat P, Lindtner R A, Schlemmer A, Vieth M & Rehak P (2012) Histopathology 60, 1060–1072
Mucinous differentiation in colorectal cancer – indicator of poor prognosis?
Aims: To analyse the prognostic impact of mucinous differentiation in colorectal mucinous adenocarcinomas and adenocarcinomas with a mucinous component.
Methods and results: A total of 381 tumours were reviewed for mucinous differentiation by two independent pathologists. Mismatch repair status was assessed by immunohistochemistry. Prognostic significance was assessed by univariate and multivariate analyses. Eighty-one (21%) tumours were Union Internationale Contre le Cancer (UICC) Stage I, 120 (31%) Stage II, 126 (33%) Stage III and 54 (14%) Stage IV. Mucinous adenocarcinomas accounted for 12% and adenocarcinomas with a mucinous component for 19% of tumours. Mucinous differentiation was associated significantly with mismatch repair protein deficiency. The presence of extracellular mucin, regardless of extent, did not affect patients’ outcome, while tumour grade, vascular and perineural invasion, tumour border configuration and budding were associated significantly with outcome. Cox analysis proved venous invasion to be an independent predictor of outcome in mucinous adenocarcinomas and both venous invasion and tumour budding as independent predictors of outcome in adenocarcinomas with any amount of mucin.
Conclusions: Mucinous adenocarcinomas and/or adenocarcinomas with mucinous component do not differ from conventional adenocarcinomas with respect to prognosis and histological predictors of outcome. Hence, recording of mucinous differentiation may be used as an indicator of mismatch repair deficiency, but not for prognostic stratification.
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