title: Mucinous differentiation in colorectal cancer--indicator of poor prognosis?
abstract: OBJECTIVE
  To analyse the prognostic impact of mucinous differentiation in colorectal mucinous adenocarcinomas and adenocarcinomas with a mucinous component.
  
  
  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.
authors.affiliation: Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, Graz, Austria. cord.langner@medunigraz.at
authors.forename: Cord
authors.initials: C
authors.lastname: Langner
authors.forename: Lars
authors.initials: L
authors.lastname: Harbaum
authors.forename: Marion J
authors.initials: MJ
authors.lastname: Pollheimer
authors.forename: Peter
authors.initials: P
authors.lastname: Kornprat
authors.forename: Richard A
authors.initials: RA
authors.lastname: Lindtner
authors.forename: Andrea
authors.initials: A
authors.lastname: Schlemmer
authors.forename: Michael
authors.initials: M
authors.lastname: Vieth
authors.forename: Peter
authors.initials: P
authors.lastname: Rehak
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D002454:Cell Differentiation; D015179:Colorectal Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D053843:DNA Mismatch Repair; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies