Introduction:Mucins play a pivotal role in epithelial carcinogenesis; however, their role remains elusive in ampulla of Vater (AoV) cancer, regardless of histological subtype. Therefore, we investigated the clinical significance of MUC1, MUC2, MUC5AC, and MUC6 expression in AoV cancer.Methods: Using samples from 68 patients with AoV cancer, we performed immunohistochemical staining for MUC1, MUC2, MUC5AC, and MUC6 using a tissue microarray. Subsequently, we analyzed their expression patterns in relation to clinicopathological parameters and patient outcomes.Results: Of the patients, 98.5% exhibited positive expression for MUC1, while MUC2, MUC5AC, and MUC6 were expressed in 44.1%, 47.1%, and 41.2% of the patients, respectively. Correlation analyses between mucin expression and clinicopathological factors revealed no significant associations, except between MUC5AC expression and N stage. Univariate analysis demonstrated significant associations between MUC5AC expression and overall survival (OS). Multivariate analysis further confirmed that MUC5AC expression was a significant predictor of OS, along with the N stage. However, MUC5AC expression was not meaningfully associated with recurrence-free survival (RFS). The patients positive for MUC5AC expression had a considerably shorter OS than those with negative expression.Conclusions: Our study provides insights into the clinical impact of mucins on AoV cancer, regardless of the histological subtype. Although MUC1 expression is universal, MUC5AC expression is a significant prognostic indicator that correlates with lymph node metastasis and poor OS. These results emphasize the possible utility of MUC5AC as a biomarker for extensive lymph node dissection and the prognostic evaluation of patients with AoV cancer.
引言：黏蛋白在上皮性癌变中起着关键作用，但其在壶腹癌（无论组织学亚型如何）中的作用尚不明确。因此，我们研究了MUC1、MUC2、MUC5AC和MUC6在壶腹癌中表达的临床意义。 方法：使用68例壶腹癌患者的样本，通过组织芯片技术对MUC1、MUC2、MUC5AC和MUC6进行免疫组化染色。随后，我们分析了这些蛋白的表达模式与临床病理参数及患者预后的关系。 结果：98.5%的患者MUC1表达呈阳性，而MUC2、MUC5AC和MUC6的表达率分别为44.1%、47.1%和41.2%。黏蛋白表达与临床病理因素的相关性分析显示，除MUC5AC表达与N分期相关外，其余均无显著关联。单因素分析表明，MUC5AC表达与总生存期显著相关。多因素分析进一步证实，MUC5AC表达与N分期均是总生存期的显著预测因子。然而，MUC5AC表达与无复发生存期无显著关联。MUC5AC表达阳性的患者总生存期明显短于表达阴性的患者。 结论：本研究揭示了黏蛋白对壶腹癌（无论组织学亚型如何）的临床影响。尽管MUC1表达普遍存在，但MUC5AC表达是一个重要的预后指标，与淋巴结转移和较差的总生存期相关。这些结果强调了MUC5AC作为生物标志物在壶腹癌患者广泛淋巴结清扫及预后评估中的潜在应用价值。
Prognostic Impact of Mucin Expression in Curatively Resected Ampulla of Vater Cancer
肿瘤(癌症)患者之家