Clinicopathological Study of Mucous Pooling Referred to as Mucinous Component (MUC) in Colorectal Submucosal Invasive Carcinomas

We investigated the significance of a pool of mucin, individually termed mucinous component (MUC), at the leading invasion edge of colorectal submucosal invasive carcinoma (SIC). In particular, we studied the correlation between pathological adverse prognostic factors and stainability of the mucosubstances and tumor-associated glycoconjugates in MUC. We demonstrated that MUCs were present in 21% of SICs, and 20% of SICs with MUC were involved in metastasis or recurrence, while only 6% of SICs without MUC were positive for it (p=0.005). SICs with MUC showed strong staining of carcinoembryonic antigen and Ulex europaeus I in the MUCs as well as in the cancer cells with high-grade atypia. Moreover, the mucins in MUCs predominantly stained for sialomucin. This study was the first to investigate the importance of mucous nodules in colorectal SIC. We concluded that MUC in SIC would be an important adverse prognostic factor, and that we should at least consider employing a similar treatment strategy for it to advanced colorectal carcinoma.