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The Prognostic Implications of FIX and FLO Patterns in Mucinous Colon Carcinomas

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Abstract

Purpose

Colon mucinous carcinomas (MUCs) have two morphological patterns: (i) glands lined by mucinous epithelium with direct contact to the stroma (FIX) and (ii) carcinoma cells floating in mucin (FLO). In this study, we evaluated the prognostic value of these patterns.

Methods

Digital images were captured from the 38 MUC’s tissue sections. A grid with 140 points was laid over the computer screen. Totally, 100 points, falling on tumor cells floating in mucin (FLO patterned cells) or on cells contacting stroma (FIX patterned cells), were counted. Tumors were grouped according to the median value of the FIX patterned cells. Cases with more than this value were grouped as FIX and less were grouped as FLO cases. The prognostic value of FIX and FLO pattern was evaluated.

Results

The median for FIX patterned cells was 66%, and the cases with lower values than this were grouped as FLO (N = 18; 47.37%), while the rest were grouped as FIX cases. There was no significant difference between FIX and FLO cases for overall survival cases (p = 0.167). For FIX cases, 62.7 and 51.3% of the patients were alive at second and third years, while this was 78.9 and 72.4% for the FLO group, respectively.

Conclusions

This is the first study using a quantitative methodology depending on count pointing to evaluate FIX/FLO feature of MUCs to the best of our knowledge, although we could not observed any prognostic and clinicopathologic relationship statistically. This distinctive feature should be studied in larger cohorts with prognostic information, with a quantitative method, like the one that was applied in this study, in order to achieve strict conclusions.

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Acknowledgments

The operations and follow-up of the patients in this series were performed by the general surgeons Selman Sokmen, Cem Terzi, Aras Emre Canda, and Mehmet Fuzun. Abdullah Haluk Sirin worked at the preparation of the follow-up data of the patients. The histopathological evaluation of the patients was performed by Sulen Sarioglu, Ozgul Sagol, and Mehtat Unlu. The hypothesis of the study was presented by Sulen Sarioglu. The mucinous carcinoma cases with follow-up information were selected by the whole authors. The methodology of the study was described by Sulen Sarioglu and performed mainly by Guray Akturk. The statistical analysis was performed by Hulya Ellidokuz, and the results were again discussed and analyzed by the whole group. The manuscript was written by Guray Akturk and Sulen Sarioglu and corrected according to the suggestions of all the authors.

The study did not require any funding. We appreciate the help of pathology archive workers Huseyin Dogan and Alperen Korana for their support with the tissue sections.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Pathology, Dokuz Eylul University, Inciralti, Izmir, Turkey

    Sulen Sarioglu, Guray Akturk, Mehtat Unlu & Ozgul Sagol

  2. Memorial Sloan Kettering Cancer Center, Department of Pathology, Precision Pathology Biobanking Center, New York, USA

    Guray Akturk

  3. Faculty of Medicine, Department of General Surgery, Dokuz Eylul University, Izmir, Turkey

    Selman Sokmen, Aras Emre Canda, Abdullah Haluk Sirin, Cem Terzi & Mehmet Fuzun

  4. Faculty of Medicine, Institute of Oncology, Dokuz Eylul University, Izmir, Turkey

    Hulya Ellidokuz

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  1. Sulen Sarioglu
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  2. Guray Akturk
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  3. Selman Sokmen
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  7. Abdullah Haluk Sirin
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  8. Ozgul Sagol
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  9. Cem Terzi
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  10. Mehmet Fuzun
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Corresponding author

Correspondence to Sulen Sarioglu.

Ethics declarations

The project was approved by the Dokuz Eylul University Ethics Committee at 25 January 2014 (no.: 873-GOA).

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The authors declare that they have no conflict of interest.

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Sarioglu, S., Akturk, G., Sokmen, S. et al. The Prognostic Implications of FIX and FLO Patterns in Mucinous Colon Carcinomas. J Gastrointest Canc 50, 254–259 (2019). https://doi.org/10.1007/s12029-018-0059-6

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  • DOI: https://doi.org/10.1007/s12029-018-0059-6

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