Skip to main content
Log in

The clinical and biological significance of the transitional mucosa adjacent to colorectal cancer

  • Review Article
  • Published:
The Japanese journal of surgery Aims and scope Submit manuscript

Abstract

The underlying nature of the transitional mucosa adjacent to colorectal cancer is defined and the evidence for and against the statement that this transitional mucosa involves primary premalignant change presented in this article. An association between mucin histochemical changes at the margins of resection and a poorer clinical outcome of patients has been recognized in patients with colorectal cancer after surgery. The retained transitional mucosa at the margins of resection appears to correlate with tumor recurrence and a poorer survival in patients who have undergone radical resection. It is considered that the transitional mucosa adjacent to colorectal cancer and its presence at the margins of resection may be an important prognostic marker for patients with large bowel cancer following radical resection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Dawson PM, Habib NA, Rees HC, Williamson RCN, Wood CB. Influence of sialomucin at the resection margin on local tumor recurrence and survival of patients with colorectal cancer: A multivariate analysis. Br J Surg 1987; 74: 366–369.

    PubMed  CAS  Google Scholar 

  2. Wang Q, Wang FM, Gao H, Chen YL, Wang YH, He J. Sialomucin at the resection margins and like-lihood of local recurrence of carcinoma of the rectum after anterior resection. Ann Med 1990; 22: 31–33.

    PubMed  CAS  Google Scholar 

  3. Andreola S, Bertario L, Bombelli L, Rossetti C, Gennari L. Abnormal pattern of mucin secretion at the resection margin of colorectal carcinomas. Tumori 1988; 74: 317–320.

    PubMed  CAS  Google Scholar 

  4. Filipe MI. Value of histochemical reactions for mucosubstances in the diagnosis of certain pathological conditions of the colon and rectum. Gut 1969; 10: 577–586.

    PubMed  CAS  Google Scholar 

  5. Filipe MI, Branfoot AC. Abnormal patterns of mucus secretion in apparently normal mucosa of large intestine with carcinoma. Cancer 1974; 34: 282–290.

    Article  PubMed  CAS  Google Scholar 

  6. Williams GT. Transitional mucosa of the large intestine. Hisatopathology 1985; 9: 1237–1243.

    CAS  Google Scholar 

  7. Filipe MI. Transitional mucosa (correspondence). Histopathology 1984; 8: 707–708.

    PubMed  CAS  Google Scholar 

  8. Forstner JF. Intestinal mucins in health and disease. Digestion 1978; 17: 234–263.

    Article  PubMed  CAS  Google Scholar 

  9. Filipe MI, Branfoot AC. Mucin histochemistry of the colon. In: Morson BC, ed. Curr Top Pathol 1976; 66: 143–178. Springer, Berlin Heidelberg New York.

    Google Scholar 

  10. Filipe MI. Malignant and inflammatory diseases of gastrointestinal tract. In: Filipe MI, Lake BD eds. Histochemistry in pathology. Edinburgh: Churchill Livingstone, 1983; 126–135.

    Google Scholar 

  11. Greaves P, Filipe MI, Abbas S, Ormerod MG. Sialomucins and carcinoembryonic antigen in the evolution of colorectal cancer. Histopathology 1984; 8: 825–834.

    PubMed  CAS  Google Scholar 

  12. Sawada T, Muto T, Agawa S, Saito Y, Adachi K. Histochemical study of goblet cell mucins in adenomas and mucosa adjacent to (“transitional mucosa”) and remote from (“background mucosa”) carcinomas of the large intestine. I to Cho (Stomach and Intestine) 1983; 18: 1235–1245. (in Japanese with English Abst.)

    Google Scholar 

  13. Saffos RO, Rhatigan RM. Benign (nonpolyoid) mucosal changes adjacent to carcinomas of the colon. Hum Pathol 1977; 8: 441–449.

    PubMed  CAS  Google Scholar 

  14. Robey-Cafferty SS, Ro JY, Ordonez NG, Cleary KR. Transitional mucosa of colon: A morphological, histochemical, and immunohistochemical study. Arch Pathol Lab Med 1990; 114: 72–75.

    PubMed  CAS  Google Scholar 

  15. Dawson PA, Filipe MI. An ultrastructural and histochemical study of the mucosa membrane adjacent to and remote from carcinoma of the colon. Cancer 1976; 37: 2388–2398.

    Article  PubMed  CAS  Google Scholar 

  16. Riddell RH, Levin B. Ultrastructure of the “transitional” mucosa adjacent to large bowel carcinoma. Cancer 1977; 40: 2509–2522.

    Article  PubMed  CAS  Google Scholar 

  17. Traynor OJ, Costa NL, Blumgart LH, Wood CB. A scanning electron microscopy study of ultrastructural changes in the colonic mucosa of patients with large bowel tumors. Br J Surg 1981; 68: 701–704.

    PubMed  CAS  Google Scholar 

  18. Shamsuddin AKM, Weiss L, Phelps PC, Trump BF. Colon epithelium. IV. Human colon carcinogenesis: Changes in human colon mucosa adjacent to and remote from carcinomas of the colon. J Natl Cancer Inst 1981; 66: 413–419.

    PubMed  CAS  Google Scholar 

  19. Isaacson P, Attwood PRA. Failure to demonstrate specificity of the morphological and histochemical changes in mucosa adjacent to colonic carcinoma (transitional mucosa). J Clin Pathol 1979; 32: 214–218.

    PubMed  CAS  Google Scholar 

  20. Hamilton PW, Watt PCH, Allen DC. A morphometric assessment of transitional mucosa in the colon. Histopathology 1988; 13: 519–530.

    Article  PubMed  CAS  Google Scholar 

  21. Lev R. A histochemical study of glycogen and mucins in developing human foetal epithelia. Histochemical J 1968; 1: 152–165.

    Article  CAS  Google Scholar 

  22. Filipe MI, Scurr JH, Ellis H. Effects of fecal stream on experimental colorectal carcinogenesis: Morphological and histochemical changes. Cancer 1982; 50: 2859–2865.

    Article  PubMed  CAS  Google Scholar 

  23. Filipe MI. Mucous secretion in rat colonic mucosa during carcinogenesis induced by dimethylhydrazine: A morphological and histochemical study. Br J Cancer 1975; 32: 60–77.

    PubMed  CAS  Google Scholar 

  24. Bara J, Decaens C, Burtin P. Early precancerous modifications in the mucus in human and rat distal colon: A comparative immunohistochemical study. Ann NY Acad Sci 1983; 417: 182–194.

    PubMed  CAS  Google Scholar 

  25. Suzuki H, Honda E, Matsumoto K, Iriyama K. Tissue CEA determination and cytophotometric DNA analysis of colorectal mucosa in patients with colorectal cancer. Jpn J Surg 1985; 15: 449–454.

    Article  PubMed  CAS  Google Scholar 

  26. Bara J, Burtin P. Mucus-associated gastrointestinal antigens in transitional mucosa adjacent to human colonic adenocarcinomas: Their fetal-type association. Eur J Cancer 1980; 16: 1303–1310.

    PubMed  CAS  Google Scholar 

  27. Bara J, André J, Gautier R, Burtin P. Abnormal pattern of mucus-associated M 1 antigens in histologically normal mucosa adjacent to colonic adenocarcinomas. Cancer Res 1984; 44: 4040–4045.

    PubMed  CAS  Google Scholar 

  28. Wang Q, Gao H, Wang FM, Wang YH, Chen YL, He J, Chang BP, Jiong JS. The imunohistochemical study of carcinoembryonic antigen in the transitional mucosa adjacent to colorectal cancer. Zhonghua Xiaohua Zazhi (Chin J Digest) 1990; 10: 25–27. (in Chinese with English Abst.)

    CAS  Google Scholar 

  29. Lapertosa G, Baracchini P, Abbas S, Fulcheri E, Tanzi R, Filipe MI. Tissue evaluation of epithelial and functional markers of cell differentiation and mucins in colonic malignancy: Assessment of diagnostic and prognostic value. Pathologica 1988; 80: 145–157.

    PubMed  CAS  Google Scholar 

  30. Shi ZR, Mcintyre LJ, Knowles BB, Solter D, Kim YS. Expression of a carbohydrate differentiation antigen, stage-specific embryonic antigen 1, in human colonic adenocarcinoma. Cancer Res 1984; 44: 1142–1147.

    PubMed  CAS  Google Scholar 

  31. Xu M, Real FX, Welt S, Schüssler MH, Oettgen HF, Old LJ. Expression of TAG-72 in normal, transitional mucosa, and colon cancer. Int J Cancer 1989; 44: 985–989.

    PubMed  CAS  Google Scholar 

  32. Boland CR, Montgomery CK, Kim YS. Alterations in human colonic mucin occurring with cellular differentiation and malignant transformation. Proc Natl Acad Sci USA 1982; 79: 2051–2055.

    Article  PubMed  CAS  Google Scholar 

  33. Cooper HS. Peanut lectin-binding sites in large bowel carcinoma. Lab Invest 1982; 47: 383–390.

    PubMed  CAS  Google Scholar 

  34. Calderó J, Campo E, Ascaso C, Ramos J, Panadés MJ, René JM. Regional distribution of glycoconjugates in normal, transitional and neoplastic human colonic mucosa: A histochemical study using lectins. Virchows Archiv A Pathol Anat 1989; 415: 347–356.

    Article  Google Scholar 

  35. Caccamo D, Telenta M, Celener D. Concanavalin A binding sites in fetal, adult, transitional, and malignant rectosigmoid mucosa. Hum Pathol 1989; 20: 1186–1192.

    PubMed  CAS  Google Scholar 

  36. Greaves P, Filipe MI, Branfoot AC. Transitional mucosa and survival in human colorectal cancer. Cancer 1980; 46: 764–770.

    Article  PubMed  CAS  Google Scholar 

  37. Habib NA, Dawson PM, Blount MA, Cox S, Krausz T, Wood CB. Study of the histochemical changes in mucus from normal and tumor bearing mucosa in patients with colorectal cancer. Eur J Surg Oncol 1985; 11: 243–245.

    PubMed  CAS  Google Scholar 

  38. Dawson PM, Habib NA, Rees HC, Wood CB. Mucosal field change in colorectal cancer. Am J Surg 1987; 153: 281–284.

    Article  PubMed  CAS  Google Scholar 

  39. Wood CB, Dawson PM, Habib NA. The sialomucin content of colonic resection margins. Dis Colon Rectum 1985; 28: 260–261.

    PubMed  CAS  Google Scholar 

  40. Dawson PM, Habib NA, Wood CB. Influence of sialomucins at the resection margin on survival of patients with colorectal cancer. Int Surg 1987; 72: 129–130.

    PubMed  CAS  Google Scholar 

  41. Wang Q, Gao H, Wang YH, Wang FM, Chen YL, He J. Influence of the transitional mucosa adjacent to rectal cancer on anastomotic tumor recurrence after anterior resection: A multivariate analysis with the Cox regression model. Zhonghua Zhongliu Zazhi (Chin J Oncol) 1991; 13 (in press). (in Chinese with English Abst.)

  42. Spratt JS, Spjut HJ. Prevalence and prognosis of individual clinical and pathological variables associated with colorectal carcinoma. Cancer 1967; 20: 1976–1985.

    Article  PubMed  Google Scholar 

  43. Chung CK, Zaino RJ, Stryker JA. Colorectal carcinoma: Evaluation of histological grade and factors influencing prognosis. J Surg Oncol 1982; 21: 143–148.

    PubMed  CAS  Google Scholar 

  44. Habib NA, Dawson PM, Bradfield JWB, Williamson RCN, Wood CB. Sialomucins at resection margin and likelihood of recurrence in colorectal carcinoma. Br Med J 1986; 293: 521–523.

    Article  CAS  Google Scholar 

  45. Habib NA, Salem R, Luck RJ, Blound MA, Rifaat MA, Wood CB. A histochemical method that predicts local recurrence after curative resection in carcinoma of the colon and rectum. Surg Gynecol Obstet 1984; 159: 436–438.

    PubMed  CAS  Google Scholar 

  46. Wang Q, Wang FM, Gao H, Wang YH, Chen YL, He J, Chang BP, Ye TJ. Relationship between mucin histochemical changes at the resection margin and rectal cancer recurrence after anterior resection. Zhonghua Waike Zazhi (Chin J Surg) 1990; 28: 274–277. (in Chinese with English Abst.)

    CAS  Google Scholar 

  47. Colacchio TA, Chabot JA, Zimmerman BW. Differential mucin staining in colorectal neoplasms: Potential clinical application. Am J Surg 1984; 147: 666–669.

    Article  PubMed  CAS  Google Scholar 

  48. Colacchio TA, Dressel D, Dunn JL. Efficacy of differential mucin staining for predicting synchronous and metachronous colorectal carcinomas. Am J Surg 1987; 153: 144–148.

    Article  PubMed  CAS  Google Scholar 

  49. Keighley MRB, Hall C. Anastomotic recurrence of colorectal cancer: A biological phenomenon or an avoidable calamity? Gut 1987; 28: 786–791.

    PubMed  CAS  Google Scholar 

  50. Umpleby HC, Williamson RCN. Anastomotic recurrence in large bowel cancer. Br J Surg 1987; 74: 873–878.

    PubMed  CAS  Google Scholar 

  51. Boland CR, Kim YS. Transitional mucosa of the colon and tumor growth factors. Med Hypotheses 1987; 22: 237–243.

    Article  PubMed  CAS  Google Scholar 

  52. Allen DC, Connolly NS, Biggart JD. High iron diamine-alcian blue mucin profiles in benign, premalignant and malignant colorectal disease. Histopathology 1988; 13: 399–411.

    PubMed  CAS  Google Scholar 

  53. Listinsky CM, Riddell RH. Patterns of mucin secretion in neoplastic and non-neoplastic diseases of the colon. Hum Pathol 1981; 12: 923–929.

    PubMed  CAS  Google Scholar 

  54. Lawson MJ, White LM, Coyle P, Butler RN, Roberts-Thomson IC, Conyers RAJ. An assessment of proliferative and enzyme activity in transitional mucosa adjacent to colonic cancer. Cancer 1989; 64: 1061–1066.

    Article  PubMed  CAS  Google Scholar 

  55. Lev R, Lance P, Camara P. Histochemical and morphological studies of mucosa bordering rectosigmoid carcinomas: Comparisons with normal, diseased, and malignant colonic epithelium. Hum Pathol 1985; 16: 151–161.

    PubMed  CAS  Google Scholar 

  56. Filipe MI. Mucins in the human gastrointestinal epithelium: A review. Invest Cell Pathol 1979; 2: 195–216.

    PubMed  CAS  Google Scholar 

  57. Filipe MI. Mucins of normal, premalignant and malignant colonic mucosa. In: Wolman SR, Mastromarino AJ, eds. Progress in Cancer Research and Therapy. 1984. vol 29, 237–251. Raven Press, New York.

    Google Scholar 

  58. Filipe MI, Mughai S, Bussey HJ. Patterns of mucus secretion in the colonic epithelium in familial polyposis. Invest Cell Pathol 1980; 3: 329–343.

    PubMed  CAS  Google Scholar 

  59. Lipkin M, Blattner WA, Gardner EJ, Burt RW, Lynch H, Deschner EE, Winawer S, Fraumeni JF. Classification and risk assessment of individuals with familial polyposis, Gardner's syndrome, and familial non-polyposis colon cancer from3H-thymidine labeling patterns in colonic epithelial cells. Cancer Res 1984; 44: 4201–4207.

    PubMed  CAS  Google Scholar 

  60. Ehsanullah M, Naunton Morgan M, Filipe MI, Gazzard B. Sialomucin in the assessment of dysplasia and cancer-risk patients with ulcerative colitis treated with colectomy and ileo-rectal anastomosis. Histopathology 1985; 9: 223–235.

    PubMed  CAS  Google Scholar 

  61. Deschner EE, Maskens AP. Significance of the labeling index and labeling distribution as kinetic parameters in colorectal mucosa of cancer patients and DMH treated animals. Cancer 1982; 50: 1136–1141.

    Article  PubMed  CAS  Google Scholar 

  62. Filipe MI, Edard MR, Ehsanullah M. A prospective study of dysplasia and carcinoma in the rectal biopsies and rectal stump of eight patients following ileorectal anastomosis in ulcerative colitis. Histopathology 1985; 9: 1139–1153.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, Q., Gao, H., Wang, Y. et al. The clinical and biological significance of the transitional mucosa adjacent to colorectal cancer. The Japanese Journal of Surgery 21, 253–261 (1991). https://doi.org/10.1007/BF02470943

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02470943

Key Words

Navigation