Neuroendocrine Differentiation in Conventional Colorectal Adenocarcinomas: Incidental Finding or Prognostic Biomarker?

MANEC colorectal adenocarcinomas neuroendocrine differentiation

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
12 Oct 2021
Historique:
received: 07 09 2021
revised: 05 10 2021
accepted: 08 10 2021
entrez: 23 10 2021
pubmed: 24 10 2021
medline: 24 10 2021
Statut: epublish

Résumé

Colorectal mixed adenoneuroendocrine carcinomas (MANECs) are clinically highly aggressive neoplasms. MANECs are composed of variable adenocarcinoma components combined with morphologically distinct neuroendocrine carcinoma components, which are confirmed by synaptophysin immunohistochemistry, the gold standard marker of a neuroendocrine differentiation. However, the biological behavior of adenocarcinomas that express synaptophysin but do not show a typical neuroendocrine morphology remains unclear. We investigated synaptophysin expression in 1002 conventional colorectal adenocarcinomas and correlated the results with clinicopathological characteristics and patient survival and compared the survival characteristics of synaptophysin expression groups to MANECs. Synaptophysin expression in conventional colorectal adenocarcinomas was associated with a shortened disease-free survival ( Our study demonstrates that synaptophysin expression in conventional colorectal adenocarcinomas, in contrast to MANECs, is not associated with a significantly poorer clinical outcome when compared to adenocarcinomas without synaptophysin expression. Furthermore, our data suggest that conventional adenocarcinomas with a diffuse synaptophysin expression should not be classified as MANECs, also strongly arguing that synaptophysin testing should be reserved for carcinomas with an H&E morphology suggestive of a neuroendocrine differentiation.

Sections du résumé

BACKGROUND BACKGROUND
Colorectal mixed adenoneuroendocrine carcinomas (MANECs) are clinically highly aggressive neoplasms. MANECs are composed of variable adenocarcinoma components combined with morphologically distinct neuroendocrine carcinoma components, which are confirmed by synaptophysin immunohistochemistry, the gold standard marker of a neuroendocrine differentiation. However, the biological behavior of adenocarcinomas that express synaptophysin but do not show a typical neuroendocrine morphology remains unclear.
METHODS METHODS
We investigated synaptophysin expression in 1002 conventional colorectal adenocarcinomas and correlated the results with clinicopathological characteristics and patient survival and compared the survival characteristics of synaptophysin expression groups to MANECs.
RESULTS RESULTS
Synaptophysin expression in conventional colorectal adenocarcinomas was associated with a shortened disease-free survival (
CONCLUSIONS CONCLUSIONS
Our study demonstrates that synaptophysin expression in conventional colorectal adenocarcinomas, in contrast to MANECs, is not associated with a significantly poorer clinical outcome when compared to adenocarcinomas without synaptophysin expression. Furthermore, our data suggest that conventional adenocarcinomas with a diffuse synaptophysin expression should not be classified as MANECs, also strongly arguing that synaptophysin testing should be reserved for carcinomas with an H&E morphology suggestive of a neuroendocrine differentiation.

Identifiants

pubmed: 34680258
pii: cancers13205111
doi: 10.3390/cancers13205111
pmc: PMC8533893
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Cancer Sci. 2014 Sep;105(9):1176-81
pubmed: 24975505
Virchows Arch. 2006 Nov;449(5):499-506
pubmed: 17033797
J Clin Diagn Res. 2015 Dec;9(12):EC01-4
pubmed: 26816894
Int J Gynecol Pathol. 2002 Oct;21(4):368-74
pubmed: 12352185
Mod Pathol. 2017 Jan;30(1):95-103
pubmed: 27586204
Cancer. 1992 Jun 1;69(11):2641-6
pubmed: 1571893
Am J Surg Pathol. 2021 Jul 1;45(7):969-978
pubmed: 34105518
Br J Cancer. 1999 Dec;81(8):1351-5
pubmed: 10604732
Arch Pathol Lab Med. 1998 Oct;122(10):912-4
pubmed: 9786353
Int J Oncol. 2006 Aug;29(2):357-64
pubmed: 16820877
Neuroendocrinology. 2017;105(4):426-434
pubmed: 28641295
World J Gastroenterol. 2003 Apr;9(4):858-61
pubmed: 12679948
J Gastrointest Surg. 2014 May;18(5):968-76
pubmed: 24549474
Mod Pathol. 2017 Apr;30(4):610-619
pubmed: 28059096
Virchows Arch. 2021 Sep;479(3):481-491
pubmed: 33733343
Cancers (Basel). 2012 Jan 16;4(1):11-30
pubmed: 24213223
World J Surg Oncol. 2017 Mar 28;15(1):71
pubmed: 28351413
Int J Cancer. 1993 Jul 9;54(5):765-71
pubmed: 8100808
Proc Natl Acad Sci U S A. 1986 May;83(10):3500-4
pubmed: 3010302
Endocr Pathol. 1998 Spring;9(1):35-42
pubmed: 12114660
Eur J Gastroenterol Hepatol. 2001 Apr;13(4):405-11
pubmed: 11338071
Oncology. 2019;97(5):294-300
pubmed: 31390635

Auteurs

Björn Konukiewitz (B)

Department of Pathology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Christian-Albrechts-Universität zu Kiel, 24105 Kiel, Germany.
Department of Pathology, Technical University of Munich, 81675 München, Germany.

Atsuko Kasajima (A)

Department of Pathology, Technical University of Munich, 81675 München, Germany.

Maxime Schmitt (M)

Department of Pathology, Technical University of Munich, 81675 München, Germany.

Kristina Schwamborn (K)

Department of Pathology, Technical University of Munich, 81675 München, Germany.

Tanja Groll (T)

Department of Pathology, Technical University of Munich, 81675 München, Germany.

Felix Schicktanz (F)

Department of Pathology, Technical University of Munich, 81675 München, Germany.

Claire Delbridge (C)

Department of Pathology, Technical University of Munich, 81675 München, Germany.

Lisa Marie Schütze (LM)

Department of Pathology, Technical University of Munich, 81675 München, Germany.

Dirk Wilhelm (D)

Department of Surgery, Klinikum Rechts der Isar, Technical University of Munich, 81675 München, Germany.

Corinna Lang (C)

Department of Pathology, Technical University of Munich, 81675 München, Germany.

Sebastian Lange (S)

II Medizinische Klinik, Klinikum Rechts der Isar, Technical University of Munich, 81675 München, Germany.

Sebastian Foersch (S)

Department of Pathology, University Hospital Mainz, 55131 Mainz, Germany.

Paul Jank (P)

Department of Pathology, University Hospital Marburg, 35403 Marburg, Germany.

Katja Steiger (K)

Department of Pathology, Technical University of Munich, 81675 München, Germany.

Alexander von Werder (AV)

II Medizinische Klinik, Klinikum Rechts der Isar, Technical University of Munich, 81675 München, Germany.

Carsten Denkert (C)

Department of Pathology, University Hospital Marburg, 35403 Marburg, Germany.

Wilko Weichert (W)

Department of Pathology, Technical University of Munich, 81675 München, Germany.

Günter Klöppel (G)

Department of Pathology, Technical University of Munich, 81675 München, Germany.

Moritz Jesinghaus (M)

Department of Pathology, Technical University of Munich, 81675 München, Germany.
Department of Pathology, University Hospital Marburg, 35403 Marburg, Germany.

Classifications MeSH