结直肠癌细胞外黏液成分的临床病理特征及预后分析

Clinicopathological characteristics and survival analysis of extracellular mucinous component in colorectal cancer

目的研究细胞外黏液成分在结直肠癌中的临床病理差异及对预后的影响。方法回顾性分析2007年3月至2010年3月收治的207例结直肠癌患者的临床病理数据。按照病理诊断分为黏液腺癌组（A组：局灶性黏液性腺癌62例；B组：黏液腺癌53例）和无黏液腺癌组（C组：低分化腺癌22例；D组：高中分化腺癌70例）。应用IBMSPSS Statistics软件，分析各组临床病理特点及生存情况。结果黏液腺癌组与无黏液腺癌组在肿瘤部位、肿瘤最大径、T分期及TNM分期差异存在统计学意义（P〈0．05），其中A组与B组相比，在性别、肿瘤最大径、T分期及N分期差异存在统计学意义（P〈0．05）；四个亚组的年龄、癌胚抗原（CEA）阳性率、肿瘤部位、肿瘤最大径、T分期、N分期、TNM分期、脉管癌栓及神经浸润差异均有统计学意义（P〈0．05）。在匹配相同TNM分期条件下，黏液腺癌组和无黏液腺癌组相比，以及四个亚组相比，3年无瘤生存率及3年总生存率差异均无统计学意义。结论结直肠腺癌细胞外黏液成分的有无以及多寡在临床病理特征上表现出一定的差异，但不是预后的独立影响因素。

Objective To explore the clinicopathological characteristics and survival analysis of colorectal carcinoma with mucinous component. Methods A total of 207 patients receiving standard- ized treatments for pathologically confirmed colorectal adenocarcinoma from March 2007 to March 2010 were recruited. For cases with mucinous component, there were group A （ad with focal mucus, n = 62） and group B （mucinous adenocarcinoma, n = 53） as studies~ for those without mucinous component, group C （poorly differentiated ad , n = 22） and group D （well or moderately differentiated adenocarcinoma, n = 70） as controls. The clinicopathological and follow-up data were collected and analyzed with IBM SPSS statistical software. Results Groups of adenocarcinoma with mucinous component differed from those of non-mucinous ad tumor volume, T stage and TNM stage （P〈0. 05）. Group of ad fered from group with mucinous ad in tumor location, with focal mucus dif in gender, tumor volume, T stage and N stage （P〈0. 05）. Also, there were significant differences in age, preoperative CEA positive count, location volume of tumor, T stage, N stage, TNM stage, groups （P〈0. 05）. At the same TNM stage, no survival rate and 3-year survival rate between ad vascular invasion and perineural invasion among 4 significant difference existed in 3-year disease-free with mucinous component and non-mucinous adenocarcinoma. It was the same for 4 groups. Conclusions The presence and quantity of extracellular mucinous component affect the clinical characteristics but not the survival of colorectal adenocarcinoma patients. Extraceltular mucus of colorectal cancer is not an independent prognostic factor.