The purpose of this study is to clarify the correlation between cell differentiation and tumor development, including tumor aggressiveness and biological behavior. Eighty-three cases of advanced colorectal adenocarcinoma were randomly selected. Using immunohistochemical staining with antibodies to CD10, MUC2 and human gastric mucin (HGM), the colorectal adenocarcinomas could be classified into five types (18 small intestinal, 27 large intestinal, 2 gastric, 9 mixed and 27 unclassified). Each type had characteristic features. The small-intestinal type showed a relatively lower incidence of lymphatic permeation and higher venous invasion. The large-intestinal type showed a low incidence of venous invasion and lymph node metastasis. The mixed type revealed female and right-side-dominant distribution, large tumor size, high incidence of mucinous carcinoma, and low incidence of venous invasion. Gastric type was seen in only two cases (2%), which exhibited high histologic grade, lymphatic permeation and lymph node metastasis with no venous invasion. Such phenotypic classifications are considered to be useful not only for evaluation of the biological behavior of the carcinoma, but also for analysis of tumorigenesis.
Key words: Colorectal carcinoma -Pheotype -MUC2 -CD10 -Human gastric mucinOn the basis of the Lauren classification, 1) gastric carcinomas were classified into two types, intestinal type and diffuse type. Following recent advances in mucin histochemistry and immunohistochemistry, it has been clarified that differentiated adenocarcinomas can be classified into two subtypes, gastric and intestinal phenotypes.
2, 3)Some authors reported that the phenotypic expression was related to the tumor growth pattern and aggressiveness. 4,5) We have already suggested that gastric carcinomas could be classified into four types (small intestinal, incomplete intestinal, gastric, and undifferentiated) by analogy with intestinal metaplasia. 6,7)