Pathological prognostic factors of pseudomyxoma peritonei
10.3760/cma.j.issn.0529?5807.2019.07.008
- VernacularTitle:腹膜假黏液瘤155例病理预后因素分析
- Author:
Fengcai YAN
1
;
Yulin LIN
;
Hongyu ZHAO
;
Quan ZHOU
;
Hong CHANG
;
Yan LI
Author Information
1. 首都医科大学附属北京世纪坛医院病理科100038
- Keywords:
Pseudomyxoma peritonei;
Appendiceal neoplasms;
Immunohistochemistry;
Prognosis;
Causality
- From:
Chinese Journal of Pathology
2019;48(7):543-549
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the pathological features of pseudomyxoma peritonei (PMP) in correlation with the survival status and independent prognostic factors. Methods One?hundred and fifty?five PMP specimens were collected at Beijing Shijitan Hospital, Capital Medical University, from 2012 to 2018. Conventional histopathological evaluation was performed to document the primary tumor site, histopathological type, lymph nodes metastasis, tumor emboli in the blood and lymph vessels, nerve invasion and cellular density. The immunohistochemical parameters including Ki?67, p53, MMR?related protein, MUC2 and MUC5AC were analyzed. Clinical follow?up data were reviewed to correlate with pathological prognostic factors using Kaplan?Meier estimator and Cox proportional hazards regression model for univariate and multivariate analysis. Results Among 155 PMP patients, there were 77 males and 78 females. There were 98 cases (63.2%) of low?grade peritoneal mucinous carcinomatosis, 49 cases (31.6%) of high?grade peritoneal mucinous carcinomatosis, 8 cases (5.2%) of high?grade mucinous carcinoma peritonei with signet ring cells; only 15 cases (9.7%) with lymph node metastasis; 18 cases (11.6%) with tumor emboli in the blood and lymph vessels; 8/126 (6.3%) were positive dMMR; 100 cases (64.5%) had Ki?67 label index<50%, and 56 cases(36.1%) presented with mutant type p53. Univariate analysis revealed 11 survival?related pathological parameters including gender, age, primary tumor site, histopathological type, lymph node metastasis, tumor emboli in the blood and lymph vessels, nerve invasion, cellular density, Ki?67 label index rate, p53 and dMMR. Multivariate analysis identified 4 independent prognostic factors including the histopathological type (HR 59.78, P<0.01), lymph node metastasis (HR 3.74, P=0.028), nerve invasion (HR 7.81, P=0.007) and dMMR (HR 9.82, P<0.01). Conclusions Histopathological type is the most important prognostic factor of PMP with dMMR as an independent molecular prognostic indicator.
