¹Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas

Correspondence: Asif Rashid, M.D., Ph.D., Department of Pathology, Box 85, M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX; fax: 713-792-5531

Accepted 8 January 2002.

Abstract

The genetic alterations of appendiceal carcinomas have not been reported in detail. We studied the clinicopathological factors and genetic alterations including microsatellite instability, p53 overexpression, and mutations of the K-ras proto-oncogene of 30 appendiceal adenocarcinomas, consisting of 23 mucinous and 7 nonmucinous carcinomas. Sixteen (70%) mucinous carcinomas presented with pseudomyxoma peritonei, but 6 of 7 (86%) nonmucinous carcinomas presented with appendicitis (P = .002). All carcinomas were microsatellite stable, and p53 overexpression was present in only 1 of 30 (3%) carcinomas. K-ras mutation was present in 11 of 20 (55%) carcinomas, including 8 of 16 (50%) mucinous and 3 of 4 (75%) nonmucinous carcinomas. The mean survival of patients with mucinous carcinomas was 26 19 months compared with 13 9 months for patients with nonmucinous carcinomas (P = .0002). Our findings suggest that mucinous and nonmucinous carcinomas of appendix have similar genetic alterations, but different clinical presentation and prognosis.