Meta-analysis of the molecular associations of mucinous colorectal cancer.

Reynolds, I S; Furney, S J; Kay, E W; McNamara, D A; Prehn, J H M; Burke, J P

Reynolds, I S; Furney, S J; Kay, E W; McNamara, D A; Prehn, J H M; Burke, J P.

Afiliación

Reynolds IS; Department of Surgery, Beaumont Hospital, Dublin, Ireland.
Furney SJ; Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland.
Kay EW; Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland.
McNamara DA; Department Pathology, Beaumont Hospital, Dublin, Ireland.
Prehn JHM; Department of Pathology, Royal College of Surgeons in Ireland, Dublin, Ireland.
Burke JP; Department of Surgery, Beaumont Hospital, Dublin, Ireland.

Br J Surg ; 106(6): 682-691, 2019 05.

Article en En | MEDLINE | ID: mdl-30945755

RESUMEN

BACKGROUND: Mucinous differentiation occurs in 5-15 per cent of colorectal adenocarcinomas. This subtype of colorectal cancer responds poorly to chemoradiotherapy and has a worse prognosis. The genetic aetiology underpinning this cancer subtype lacks consensus. The aim of this study was to use meta-analytical techniques to clarify the molecular associations of mucinous colorectal cancer. METHODS: This study adhered to MOOSE guidelines. Databases were searched for studies comparing KRAS, BRAF, microsatellite instability (MSI), CpG island methylator phenotype (CIMP), p53 and p27 status between patients with mucinous and non-mucinous colorectal adenocarcinoma. A random-effects model was used for analysis. RESULTS: Data from 46 studies describing 17 746 patients were included. Mucinous colorectal adenocarcinoma was associated positively with KRAS (odds ratio (OR) 1·46, 95 per cent c.i. 1·08 to 2·00, P = 0·014) and BRAF (OR 3·49, 2·50 to 4·87; P < 0·001) mutation, MSI (OR 3·98, 3·30 to 4·79; P < 0·001) and CIMP (OR 3·56, 2·85 to 4·43; P < 0·001), and negatively with altered p53 expression (OR 0·46, 0·31 to 0·67; P < 0·001). CONCLUSION: The genetic origins of mucinous colorectal adenocarcinoma are predominantly associated with BRAF, MSI and CIMP pathways. This pattern of molecular alterations may in part explain the resistance to standard chemotherapy regimens seen in mucinous adenocarcinoma.

Asunto(s)

Adenocarcinoma Mucinoso/genética; Biomarcadores de Tumor/genética; Neoplasias Colorrectales/genética; Regulación Neoplásica de la Expresión Génica; Adenocarcinoma Mucinoso/patología; Neoplasias Colorrectales/patología; Islas de CpG/genética; Metilación de ADN; Humanos; Inestabilidad de Microsatélites; Modelos Estadísticos; Mutación; Fenotipo; Antígeno Nuclear de Célula en Proliferación/genética; Proteínas Proto-Oncogénicas B-raf/genética; Proteínas Proto-Oncogénicas p21(ras)/genética; Proteína p53 Supresora de Tumor/genética

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Biomarcadores de Tumor / Regulación Neoplásica de la Expresión Génica / Adenocarcinoma Mucinoso Tipo de estudio: Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Br J Surg Año: 2019 Tipo del documento: Article País de afiliación: Irlanda Pais de publicación: Reino Unido

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