Adenocarcinoma within anorectal fistulae: different clinicopathological characteristics between Crohn's disease-associated type and the usual type

被引：9

作者：

Kodama, Makoto ^{[1
,2
]}

Kobayashi, Daisuke ^{[1
]}

Iihara, Kuniko ^{[2
]}

Abe, Keiko ^{[2
]}

Sahara, Rikisaburo ^{[3
]}

Sassa, Motoki ^{[3
]}

Yamana, Tetsuo ^{[3
]}

Furukawa, Satomi ^{[3
]}

Yao, Takashi ^{[4
]}

Uchida, Keisuke ^{[5
]}

Tamura, Tomoki ^{[5
]}

Negi, Mariko ^{[1
]}

Eishi, Yoshinobu ^{[1
]}

机构：

[1] Tokyo Med & Dent Univ, Dept Human Pathol, Bunkyo Ku, 1-5-45 Yushima, Tokyo, Japan

[2] Tokyo Yamate Med Ctr, Dept Pathol, Shinjuku Ku, 3-22-1 Hyakunincho, Tokyo, Japan

[3] Tokyo Yamate Med Ctr, Dept Coloproctol Ctr, Shinjuku Ku, 3-22-1 Hyakunincho, Tokyo, Japan

[4] Juntendo Univ, Grad Sch Med, Dept Human Pathol, Bunkyo Ku, 2-1-1 Hongo, Tokyo, Japan

[5] Tokyo Med & Dent Univ Hosp, Div Surg Pathol, Bunkyo Ku, 1-5-45 Yushima, Tokyo, Japan

来源：

MODERN PATHOLOGY | 2019年 / 32卷 / 02期

关键词：

COLORECTAL-CANCER; EXPRESSION; MUC5AC; MUC2; MANAGEMENT; CARCINOMAS; SURVIVAL; COLON; P53;

D O I：

10.1038/s41379-018-0105-8

中图分类号：

R36 [病理学];

学科分类号：

100104 ;

摘要：

Adenocarcinoma within anorectal fistulae is rare and is sometimes associated with Crohn's disease. Crohn's disease-associated adenocarcinoma within anorectal fistulae has a poor prognosis; however, little is known about the clinicopathological differences between Crohn's disease-associated adenocarcinoma within anorectal fistulae and usual adenocarcinoma within anorectal fistulae. We retrospectively searched patients' charts and pathology archives at Tokyo Yamate Medical Center and Tokyo Medical and Dental University Hospital for adenocarcinoma within anorectal fistulae. Clinical and pathological data were collected and immunohistochemical examinations were conducted. Overall survival rate was estimated using the Kaplan-Meier method. Prognostic factors of overall survival were assessed using univariate and multivariate Cox regression analyses. We examined 82 cases of adenocarcinoma within anorectal fistulae. Fifty-nine of 82 cases (72%) had usual adenocarcinoma within anorectal fistulae, while the remaining 23 cases (28%) had Crohn's diseaseassociated adenocarcinoma within anorectal fistulae. Patients with Crohn's disease-associated adenocarcinoma within anorectal fistulae were diagnosed at a younger age and at a more advanced stage than those with usual adenocarcinoma within anorectal fistulae. Macroscopic and histological types were also different between usual adenocarcinoma within anorectal fistulae and Crohn's disease-associated adenocarcinoma within anorectal fistulae. Crohn's disease-associated adenocarcinoma within anorectal fistulae included more ulcerative types and high-grade adenocarcinomas. The rate of lymphovascular invasion was higher in Crohn's disease-associated adenocarcinoma within anorectal fistulae. Immunohistochemically, the expression of E-cadherin, p53, and MUC5AC differed between usual adenocarcinoma within anorectal fistulae and Crohn's disease-associated adenocarcinoma within anorectal fistulae. Patients with Crohn's disease-associated adenocarcinoma within anorectal fistulae exhibited worse overall survival than those with usual adenocarcinoma within anorectal fistulae, and vascular invasion was the strongest significant independent predictor of overall survival in patients with adenocarcinoma within anorectal fistulae. In conclusion, usual adenocarcinoma within anorectal fistulae and Crohn's disease-associated adenocarcinoma within anorectal fistulae have different clinicopathological characteristics and should be considered separate clinical entities.

引用

页码：314 / 325

页数：12