背景：目前关于结肠腺癌（AC）的两种不同组织学亚型（粘液性腺癌（MAC）和环形细胞癌（SRCC））的自然史和预后，了解有限。因此，本研究旨在使用美国大型病例队列，研究结肠MAC和SRCC的临床病理特征，并与经典型AC进行比较。方法：本研究纳入了2000年至2018年期间在SEER数据库中诊断为结肠AC、MAC或SRCC的患者。我们分析了发病趋势、患者人口统计学特征、肿瘤特征、治疗和生存情况。结果：在我们的研究中，共分析了310,813例结肠癌患者，其中包括271,382例古典型AC、34,750例MAC和4,681例SRCC。在研究期间，我们观察到结肠AC、MAC和SRCC的年龄调整发病率下降。值得注意的是，MAC和SRCC队列在患者特征、肿瘤位置和治疗模式方面与AC存在显著差异。与AC相比，MAC和SRCC患者的生存结果较差。与较差生存相关的因素包括年龄较大、男性性别、恶性程度较差的肿瘤、晚期、以及MAC或SRCC组织形态的存在。另一方面，手术干预与生存改善相关。结论：我们的研究强调了认识不同结肠癌组织学亚型的明显特征和预后相关性的重要性。有必要进一步研究造成这些差异的潜在生物特征，并制定更具针对性的治疗策略。Copyright © 2023 Liu, Yin, Li, Li, Liu and Kang.

Background: Limited information is currently available on the natural history and prognosis of two distinct histological subtypes of adenocarcinoma (AC) in the colon: mucinous adenocarcinoma (MAC) and signet-ring cell carcinoma (SRCC). Therefore, the aim of this study is to examine the clinicopathological characteristics of colon MAC and SRCC, comparing them to classical AC, using a large cohort of cases from the United States. Methods: Patients diagnosed with colon AC, MAC, or SRCC from the SEER database between 2000 and 2018 were included in our study. Incidence trends, patient demographics, tumor characteristics, treatment, and survival were analyzed. Results: In our study, we analyzed a total of 310,813 patients with colon cancers, including 271,382 cases of classical AC, 34,750 cases of MAC, and 4,681 cases of SRCC. Over the study period, we observed a decline in the age-adjusted incidence rates of colon AC, MAC, and SRCC. Notably, the MAC and SRCC cohorts differed significantly from AC in terms of patient characteristics, tumor locations, and treatment patterns. Patients with MAC and SRCC had poorer survival outcomes compared to those with AC. Factors associated with worse survival included older age, male sex, poorly differentiated tumors, advanced stage, and the presence of MAC or SRCC histology. On the other hand, surgical intervention was associated with improved survival. Conclusion: Our study underscores the significance of recognizing the distinct features and outcomes associated with different histological subtypes of colon cancer. Further research is warranted to delve into the underlying biological traits that contribute to these differences and to develop more tailored treatment strategies.Copyright © 2023 Liu, Yin, Li, Li, Liu and Kang.