Adenocarcinoma with mixed subtypes is a rare but aggressive histologic subtype in colorectal cancer
Hui Sheng,
Xiaoli Wei,
Minjie Mao,
Jincan He,
Tianqi Luo,
Shilin Lu,
Liye Zhou,
Zhixin Huang,
Anli Yang
Affiliations
Hui Sheng
Department of Experimental Research, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
Xiaoli Wei
Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
Minjie Mao
Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
Jincan He
Zhongshan School of Medicine, Sun Yat-sen University
Tianqi Luo
Department of Gastric Surgery, Sun Yat-sen university Cancer center, State key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
Shilin Lu
Zhongshan School of Medicine, Sun Yat-sen University
Liye Zhou
Department of Medical Oncology, Dana-Farber Cancer Institute
Zhixin Huang
Department of Emergency, Foshan Traditional Chinese Medicine Chancheng High-tech Zone Hospital
Anli Yang
Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
Abstract Background Although numerous studies have investigated the clinicopathologic and prognostic relevance of mucinous adenocarcinoma (MAC) and signet-ring cell carcinoma (SRCC) compared with classic adenocarcinoma (CA), little is known about the prognosis of adenocarcinoma with mixed subtypes (AM) and the differences among these four subtypes. Methods The statistics of colorectal cancer registered in the Surveillance, Epidemiology and End Results (SEER) database were retrieved and analyzed. We also compared the clinicopathologic and prognostic relevance between CA, SRCC, MAC, and AM. Results The frequencies of these four subtypes were 69.9% (CA, n = 15,812), 25.1% (MAC, n = 5689), 3.6% (SRCC, n = 814) and 1.4% (AM, n = 321), respectively. All of MAC, SRCC, and AM were significantly related with aggressive features. Only SRCC and AM were identified as independent poor prognostic markers for overall survival by multivariate analysis. The aggressiveness of AM was between MAC and SRCC according to the clinicopathologic associations. The prognosis of AM was significantly worse than MAC but comparable with SRCC. Conclusions We confirmed the clinicopathologic relevance with aggressive features of MAC and SRCC, as well as poor prognostic relevance of SRCC by analyzing a large study population data set. Furthermore, we identified AM as a rare but aggressive histologic subtype in colorectal cancer, to which particular attention should be given in clinical practice.
