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Prognostic value of mucin 4 expression in colorectal adenocarcinomas
Author(s) -
Shanmugam Chandrakumar,
Jhala Nirag C.,
Katkoori Venkat R.,
Wan Wen,
Meleth Sreelatha,
Grizzle William E.,
Manne Upender
Publication year - 2010
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.25095
Subject(s) - medicine , stage (stratigraphy) , immunostaining , proportional hazards model , hazard ratio , colorectal cancer , confidence interval , immunohistochemistry , oncology , mucin , adenocarcinoma , pathology , survival analysis , gastroenterology , cancer , biology , paleontology
BACKGROUND: Mucin 4 (MUC4) is aberrantly expressed in colorectal adenocarcinomas (CRCs) but its prognostic value is unknown. METHODS: Archival tissue specimens collected from 132 CRC patients who underwent surgical resection without presurgery or postsurgery therapy were evaluated for expression of MUC4 by using a mouse monoclonal antibody and horseradish peroxidase. MUC4 expression levels were correlated with clinicopathologic features and patient survival. Survival was estimated by both univariate Kaplan‐Meier and multivariate Cox regression methods. RESULTS: In both normal colonic epithelium and CRCs, MUC4 staining was localized primarily in the cytoplasm. The optimal immunostaining cutoff value (≥75% positive cells and an immunostaining score ≥2.0), which was derived by using the bootstrap method, was used to categorize CRCs into groups of high expression (33 of 132 patients; 25%) or low expression (99 of 132 patients; 75%). Patients who had early stage tumors (stages I and II) with high MUC4 expression had a shorter disease‐specific survival (log‐rank; P = .007) than patients who had with low expression. Patients who had advanced‐stage CRCs (stages III and IV) did not demonstrate such a difference (log‐rank; P = .108). Multivariate regression models that were generated separately for patients with early stage and advanced‐stage CRC confirmed that increased expression of MUC4 was an independent indicator of a poor prognosis only for patients who had early stage CRCs (hazard ratio, 3.77; 95% confidence interval, 1.46‐9.73). CONCLUSIONS: The current results indicated that increased MUC4 expression is a predictor of poor survival in CRC, specifically for patients who have early stage tumors. Cancer 2010. © 2010 American Cancer Society.