Mucinous adenocarcinoma of the colon and rectum: A genomic analysis

J Surg Oncol. 2019 Dec;120(8):1427-1435. doi: 10.1002/jso.25764. Epub 2019 Nov 14.

Abstract

Background and objectives: Mucinous adenocarcinoma is a distinct subtype of colorectal cancer (CRC) with a worse prognosis when compared with non-mucinous adenocarcinoma. The aim of this study was to compare somatic mutations and copy number alteration (CNA) between mucinous and non-mucinous CRC.

Methods: Data from The Cancer Genome Atlas-colon adenocarcinoma and rectum adenocarcinoma projects were utilized. Mucinous and non-mucinous CRC were compared with regard to microsatellite status, overall mutation rate, the most frequently mutated genes, mutations in genes coding for mismatch repair (MMR) proteins and genes coding for mucin glycoproteins. CNA analysis and pathway analysis was undertaken.

Results: Mucinous CRC was more likely to be microsatellite instability-high (MSI-H) and hypermutated. When corrected for microsatellite status the single-nucleotide variation and insertion-deletion rate was similar between the two cohorts. Mucinous adenocarcinoma was more likely to have mutations in genes coding for MMR proteins and mucin glycoproteins. Pathway analysis revealed further differences between the two histological subtypes in the cell cycle, RTK-RAS, transforming growth factor-β, and TP53 pathways.

Conclusions: Mucinous CRC has some distinct genomic aberrations when compared with non-mucinous adenocarcinoma, many of which are driven by the increased frequency of MSI-H tumors. These genomic aberrations may play an important part in the difference seen in response to treatment and prognosis in mucinous adenocarcinoma.

Keywords: colorectal cancer; mucinous adenocarcinoma; oncogenetics.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / genetics*
  • Adenocarcinoma / pathology
  • Adenocarcinoma, Mucinous / genetics*
  • Adenocarcinoma, Mucinous / pathology
  • Cohort Studies
  • Colonic Neoplasms / genetics*
  • Colonic Neoplasms / pathology
  • DNA Copy Number Variations
  • DNA-Binding Proteins / genetics
  • Datasets as Topic
  • Gene Expression Regulation, Neoplastic
  • Genomics*
  • Humans
  • INDEL Mutation
  • Microsatellite Instability
  • Mucins / genetics
  • Mutation
  • Polymorphism, Single Nucleotide
  • Proto-Oncogene Proteins B-raf / genetics
  • Proto-Oncogene Proteins p21(ras) / genetics
  • Rectal Neoplasms / genetics*
  • Rectal Neoplasms / pathology
  • Smad4 Protein / genetics
  • Transforming Growth Factor beta / genetics
  • Tumor Suppressor Protein p53 / genetics

Substances

  • DNA-Binding Proteins
  • G-T mismatch-binding protein
  • KRAS protein, human
  • Mucins
  • SMAD4 protein, human
  • Smad4 Protein
  • TP53 protein, human
  • Transforming Growth Factor beta
  • Tumor Suppressor Protein p53
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • Proto-Oncogene Proteins p21(ras)