Scholarlink

Purpose <p>Mucinous adenocarcinoma (MAC) is a distinct and aggressive subtype of colorectal cancer (CRC), traditionally defined by &gt; 50% mucinous component. However, evidence suggests tumors with lower mucin content may behave similarly. This study investigated clinicopathological and molecular differences between mucinous and non-mucinous CRC, and evaluated the prognostic relevance of the current mucin threshold.</p> Methods <p>We retrospectively analyzed 1716 CRC cases (2017–2021) from the Institut Pasteur de Tunis. Tumors were classified as NMAC (0–5% mucin), ACMC1 (5–50%), or MAC (&gt; 50%). .RAS mutation status was determined using Lightmix (TibMolBiol). Clinical, histological, and metastatic features comparison across groups and survival analysis were assessed using SPSS v26.</p> Results <p>Tumors with any mucinous component (5–100%) were significantly associated with right-sided location (<i>p</i> &lt; 0.001), signet-ring cells (<i>p</i> &lt; 0.001), synchronous peritoneal metastasis (<i>p</i> = 0.002–0.02), and <i>KRAS</i> mutations (<i>p</i> = 0.031) versus NMAC. Importantly, ACMC1 (5–50%) shared aggressive features with MAC, including lymphovascular invasion (<i>p</i> = 0.027) and distinct metastatic patterns.</p> Conclusions <p>Our findings debate the WHO 50% mucin threshold, showing that tumors with 5–50% mucin exhibit comparable aggressiveness to classical MAC. Integrating molecular profiling with histology may improve risk stratification and guide tailored therapeutic strategies for mucinous CRC, regardless of mucin proportion.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Rethinking mucinous colorectal adenocarcinoma classification: evidence from histopathology and RAS mutations

  • 期刊论文

  • 发表日期：

    2026年4月14日

查看全文
  • Dorra Wider,
  • Haifa Tounsi Guettiti,
  • Monia Ardhaoui,
  • Amira Jaballah-Gabteni,
  • Jihenne Ben Aissa,
  • Ines Ben Ayed,
  • Nadia Ben Jemii,
  • Hamza Yaiche,
  • Emna Fehri,
  • Essia Habachi,
  • Afifa Maaloul,
  • Emna Ennaifer,
  • Samir Boubaker

摘要

Purpose

Mucinous adenocarcinoma (MAC) is a distinct and aggressive subtype of colorectal cancer (CRC), traditionally defined by > 50% mucinous component. However, evidence suggests tumors with lower mucin content may behave similarly. This study investigated clinicopathological and molecular differences between mucinous and non-mucinous CRC, and evaluated the prognostic relevance of the current mucin threshold.

Methods

We retrospectively analyzed 1716 CRC cases (2017–2021) from the Institut Pasteur de Tunis. Tumors were classified as NMAC (0–5% mucin), ACMC1 (5–50%), or MAC (> 50%). .RAS mutation status was determined using Lightmix (TibMolBiol). Clinical, histological, and metastatic features comparison across groups and survival analysis were assessed using SPSS v26.

Results

Tumors with any mucinous component (5–100%) were significantly associated with right-sided location (p < 0.001), signet-ring cells (p < 0.001), synchronous peritoneal metastasis (p = 0.002–0.02), and KRAS mutations (p = 0.031) versus NMAC. Importantly, ACMC1 (5–50%) shared aggressive features with MAC, including lymphovascular invasion (p = 0.027) and distinct metastatic patterns.

Conclusions

Our findings debate the WHO 50% mucin threshold, showing that tumors with 5–50% mucin exhibit comparable aggressiveness to classical MAC. Integrating molecular profiling with histology may improve risk stratification and guide tailored therapeutic strategies for mucinous CRC, regardless of mucin proportion.