Cancer Medicine (Apr 2023)

Immunophenotypic profiles and prognosis for colorectal mucinous adenocarcinomas are dependent on anatomic location

  • Chirag Patel,
  • Michael Behring,
  • Sameer Al Diffalha,
  • Deepti Dhall,
  • Goo Lee,
  • Chandrakumar Shanmugam,
  • William E. Grizzle,
  • Upender Manne

DOI
https://doi.org/10.1002/cam4.5803
Journal volume & issue
Vol. 12, no. 8
pp. 9637 – 9643

Abstract

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Abstract Background The prognostic value of mucinous adenocarcinomas (MCAs, exhibiting >50% extracellular mucin) of the colorectum, in relation to their anatomic location is not well studied. Materials and Methods We compared MCAs (n = 175) with non‐MCAs (NMCAs, n = 1015) and the cancer‐specific survival rates were evaluated, based on their anatomic site, by univariate Kaplan–Meier and multivariate Cox methods. Subsets of these tumors were immunostained for MUC1, MUC2, Bcl‐2, and p53. Results MCAs were more commonly found in the right colon, were of high‐grade, and were more prevalent in younger patients (<40 years). They exhibited strong expression of MUC2 and Bcl‐2 and showed less p53 nuclear staining. In contrast, most NMCAs were low‐grade with high expression of MUC1. MCAs of the rectum were associated with poorer outcomes relative to NMCAs (HR 1.85, CI 95% 1.15–2.97), even though the distributions of advanced‐stage tumors were similar. Conclusion Late‐stage disease and age were poor independent prognostic indicators of cancer‐specific deaths across all tumor locations. In summary, rectal MCAs have a poor prognosis.

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