Pathological prognostic factors of pseudomyxoma peritonei: comprehensive clinicopathological analysis of 155 cases

被引:14
作者
Yan, Fengcai [1 ]
Lin, Yulin [2 ]
Zhou, Quan [1 ]
Chang, Hong [1 ]
Li, Yan [1 ,2 ]
机构
[1] Capital Med Univ, Beijing Shijitan Hosp, Dept Pathol, Beijing 100038, Peoples R China
[2] Capital Med Univ, Beijing Shijitan Hosp, Dept Peritoneal Canc Surg, Beijing 100038, Peoples R China
基金
北京市自然科学基金;
关键词
Pseudomyxoma peritonei; Appendiceal neoplasm; Prognosis; Pathological grading; Mismatch repair genes; CLASSIFICATION; TUMORS; GRADE; KI67;
D O I
10.1016/j.humpath.2019.12.008
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Background: Pseudomyxoma peritonei (PMP) is an extremely rare malignancy, characterized by extensive peritoneal implantation and colloidal ascites. This study was to explore the pathological prognostic factors of PMP. Methods: Specimens from 155 PMP patients were analyzed by H&E and immunohistochemistry. Parameters included primary tumor location, histological grade, lymph node metastasis, tumor emboli in the blood and lymph vessels, perineural invasion, Ki67 labeling index. p53. mismatch repair (MMR) gene mutations, MUC1, MUC2, MUC5AC, and MUC6. Clinicopathological and follow-up data were subjected to univariate and multivariate analyses. Results: The patients included 63.2% (n = 98) low-grade mucinous carcinoma peritonei. 31.6% (n = 49) high-grade mucinous carcinoma peritonei and 5.2% (n = 8) high-grade mucinous carcinoma peritonei with signet ring cells. There were 9.7% (n = 15) with lymph node metastasis; 11.6% (n = 18) with angiolymphatic invasion; 6.3% (n = 8) with defective MMR (dMMR); 35.5% (n = 55) with Ki67 labeling index >= 50%; 36.1% (n = 56) with p53 mutation. For PMP from appendiceal origin (n =140), univariate analysis identified 10 potential prognostic factors. But Multivariate analysis identified only histologic grade was the independent prognostic factor for OS. Mortality risk of high-grade peritoneal mucinous carcinoma or high-grade peritoneal mucinous carcinoma with signet ring cells was 7.056 times (P < .0001, 95% CI: 2.701-18.435) or 27.224 times (P < .0001, 95% CI: 6.207-119.408), respectively, higher than low-grade. Conclusions: For PMP from the appendiceal origin, histological grade could be the only independent prognostic factor. (C) 2020 The Author(s). Published by Elsevier Inc.
引用
收藏
页码:9 / 18
页数:10
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