Survival in oesophago-gastric cancer (OGC) is poor due to early diagnostic challenges. Non-invasive risk stratification may identify susceptible patients with pre-malignant or benign disease. Following diagnostic confirmation with endoscopic biopsy, early OGC may be treated sooner. Mucins are transmembrane glycoproteins implicated in OGC with potential use as biomarkers of malignant transformation. This systematic review defines the role of mucins in OGC diagnosis. A literature search of MEDLINE, Web of Science, Embase and Cochrane databases was performed following PRISMA protocols for studies published January 1960–December 2022. Demographic data and data on mucin sampling and analysis methods were extracted. The review included 124 studies (n= 11,386 patients). Gastric adenocarcinoma (GAc) was the commonest OG malignancy (n= 101) followed by oesophageal adenocarcinoma (OAc,n= 24) and squamous cell carcinoma (OSqCc,n= 10). Mucins MUC1, MUC2, MUC5AC and MUC6 were the most frequently implicated. High MUC1 expression correlated with poorer prognosis and metastases in OSqCc. MUC2 expression decreases during progression from healthy mucosa to OAc, causing reduced protection from gastric acid. MUC5AC was upregulated, and MUC6 downregulated in GAc. Mucin expression varies in OGC; changes may be epigenetic or mutational. Profiling upper GI mucin expression in OGC, with pre-malignant, benign and healthy controls may identify potential early diagnostic biomarkers.
食管胃结合部癌（OGC）因早期诊断困难而预后不佳。无创风险分层可识别具有癌前病变或良性疾病的易感患者。通过内镜活检确诊后，早期OGC可得到更及时的治疗。黏蛋白作为跨膜糖蛋白参与OGC发生发展，具有作为恶性转化生物标志物的潜力。本系统综述旨在明确黏蛋白在OGC诊断中的作用。遵循PRISMA指南，对1960年1月至2022年12月期间发表于MEDLINE、Web of Science、Embase和Cochrane数据库的研究进行文献检索。提取人口统计学数据及黏蛋白采样分析方法数据。共纳入124项研究（n=11,386例患者）。胃腺癌（GAc）是最常见的OG恶性肿瘤（n=101），其次为食管腺癌（OAc，n=24）和鳞状细胞癌（OSqCc，n=10）。MUC1、MUC2、MUC5AC和MUC6是最常涉及的黏蛋白。MUC1高表达与OSqCc不良预后和转移相关。从健康黏膜进展至OAc过程中MUC2表达降低，导致胃酸防护能力下降。GAc中MUC5AC表达上调，MUC6表达下调。黏蛋白在OGC中表达存在差异，其变化可能涉及表观遗传或基因突变。通过对比分析OGC与癌前病变、良性病变及健康对照的上消化道黏蛋白表达谱，可能发现潜在的早期诊断生物标志物。
肿瘤(癌症)患者之家