Poorly differentiated colonic adenocarcinoma, medullary type : Clinical, phenotypic, and molecular characteristics

摘要: Clinicopathological evidence has accumulated that colorectal adenocarcinoma with minimal or no glandular differentiation constitutes two entities different prognosis. In a series of 20 predominantly nonglandular, poorly differentiated adenocarcinomas, histological features, DNA content, p53 protein expression, Ki-ras mutation, and microsatellite instability were analyzed correlated to the biology tumors. addition, presence Epstein-Barr virus (EBV) transcripts was tested by RNA in situ hybridization EBV demonstrated nested polymerase chain reaction. Histologically, 13 tumors showed small uniform cells 7 large pleomorphic cells. Tumors exhibited more commonly an expansive growth pattern (69.2% versus 0%; P < 0.025) dense peritumor lymphoid infiltrate (84.6% 14.3%; 0.01) resembling their gastric counterpart, solid medullary carcinoma. These less frequent lymph node as well hematogeneous metastases than carcinomas. they usually diploid 28.6%; 0.05) lacked stabilization (0% 42.9%; 0.05). No significant difference between tumor type found respect bcl2 expression occurrence mutations at codon 12. contrast, almost totally restricted adenocarcinomas (100% 0.001). Finally, reaction revealed 5 specimens, which was, however, shown hybridization. Correlation only one patient cell died due metastastic disease during follow-up period (median, 31 months), case five seven patients pleomorphic-type carcinoma (P 0.025). Our results clearly indicate colonic structures constitute entities, variant, markedly differ phenotype, genotype,