Expression of MUC5AC in colorectal carcinoma and relationship with prognosis

Abstract

Overexpression and alterations in the glycosylation of gastric mucins have been described in colorectal carcinoma. The purpose of our study was to confirm aberrant expression of MUC5AC in colorectal carcinoma, to investigate relationships between clinicopathological parameters and MUC5AC expression, and to determine if MUC5AC expression may be a prognostic factor for colorectal carcinoma. Immunohistochemical staining using an antibody against MUC5AC tandem repeat epitopes was performed on colorectal tumor specimens (n = 41), their metastatic tumors in regional lymph nodes (n = 21) and normal colonic mucosa (n = 41). We also documented clinicopathological parameters such as the age and sex of the patient, location, size, Dukes stage, histological type and grade of the tumor, pre-sence and number of metastatic lymph nodes, lymphatic, venous and perineural invasion, presence of preoperative and postoperative metastatic tumors and tumor recurrence. MUC5AC was expressed in 34.1% of tumor samples, 24.4% of normal colonic mucosa samples and 19% of lymph node metastases. MUC5AC showed ectopic expression in colorectal carcinoma and was also expressed strongly in mucinous carcinoma (60%). The number of tumors that expressed MUC5AC was lower in patients older than 60 years, in rectum-localized tumors and in patients who had evidence of recurrence and/or metastasis in the postoperative period. The patients with MUC5AC-negative tumors had a lower incidence of being disease free and of overall survival. In conclusion, the patients with MUC5AC-negative tumors had poor clinicopathological parameters and showed worse survival than patients with MUC5AC-positive tumors. Absence of MUC5AC expression in tumors can be a prognostic factor for more aggressive colorectal carcinoma.

Expression of survivin, MUC2 and MUC5 in colorectal cancer and their association with clinicopathological characteristics

“…1 and Table I). Similarly, other studies have shown that MUC5AC is not detected in the normal colon, but is frequently found in adenomas and carcinomas (18,(30)(31)(32). Other prior studies reported that an increase in expression of MUC5AC was observed in sporadic cancer with high microsatellite instability (33) and that MUC5AC expression in intrahepatic cholangiocarcinoma was found to be an independent prognostic factor by multivariate survival analysis (34).…”

“…Other prior studies reported that an increase in expression of MUC5AC was observed in sporadic cancer with high microsatellite instability (33) and that MUC5AC expression in intrahepatic cholangiocarcinoma was found to be an independent prognostic factor by multivariate survival analysis (34). The presence of MUC2 and/or MUC5AC in colorectal mucinous adenocarcinoma has been shown to be associated with proximal (right-sided) CRC location (32,33). There was no statistically significant association between gender and expression of MUC2 and/or MUC5 in the present study.…”

Comparison between colorectal low- and high-grade mucinous adenocarcinoma with MUC1 and MUC5AC

“…MUC5AC is expressed in adenoma and conventional adenocarcinoma with well to moderate differentiation in the colon and rectum [16][17][18][19][20] . In addition, MUC5AC has also been reported to be expressed in 56%-63% cases of colorectal MAC [17,18] .…”

“…In addition, MUC5AC has also been reported to be expressed in 56%-63% cases of colorectal MAC [17,18] . On the other hand, Kocer et al [19] have reported that the absence of MUC5AC expression in tumors can be a prognostic factor for more aggressive adenocarcinoma in the colon and rectum. In this study, we found that the frequency of MUC5AC/CHL2 expression was significantly lower in high-grade MAC compared with low-grade MAC.…”

Mucinous carcinoma of the rectum: a distinct clinicopathological entity

“…MUC1 expression is low in mucinous tumours but in those tumours that show overexpression, there is an association with worse prognosis and chemoresistivity to certain chemotherapy agents [51]. Conversely, the MUC5 gene has been shown to confer a survival benefit [52] and unusually is overexpressed in some mucinous tumours. However, MUC5 also shows a greater association with proximal location of the colorectum, which may explain the poor prognosis of mucinous rectal cancer; that this may be due to relative underexpression of MUC5.…”