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Original article
MUC4 expression is a novel prognostic factor in patients with invasive ductal carcinoma of the pancreas
  1. M Saitou1,
  2. M Goto1,
  3. M Horinouchi2,
  4. S Tamada1,
  5. K Nagata1,
  6. T Hamada1,
  7. M Osako3,
  8. S Takao4,
  9. S K Batra5,
  10. T Aikou6,
  11. K Imai7,
  12. S Yonezawa1
  1. 1Department of Human Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
  2. 2Department of Pathology, Kagoshima Medical Association Hospital, 890-0064, Japan
  3. 3Department of Surgery, Kagoshima Medical Association Hospital
  4. 4Research Centre for Life Science Resources, Kagoshima University, Kagoshima 890-8544, Japan
  5. 5Departments of Biochemistry and Molecular Biology, Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE 68198-4525, USA
  6. 6Surgical Oncology and Digestive Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences
  7. 7Department of Internal Medicine, Sapporo Medical College, Sapporo 060-8556, Japan
  1. Correspondence to:
 Dr S Yonezawa
 Department of Human Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan; syonezam2.kufm.kagoshima-u.ac.jp

Abstract

Background: Many patients with invasive ductal carcinoma of the pancreas (IDC) have a poor outcome. MUC4 expression has been implicated as a marker for diagnosis and progression of IDC, but there are no studies of the relation between MUC4 expression and patient prognosis in IDC.

Aims: To investigate the prognostic significance of MUC4 expression in IDC.

Methods: The expression profiles of MUC4, ErbB2, p27, and MUC1 were investigated in IDC tissues from 135 patients by means of immunohistochemistry.

Results: MUC4 was expressed in 43 of the 135 patients with IDC (31.9%). The survival of 21 patients with high MUC4 expression (>20% of neoplastic cells stained) was significantly worse than that of the 114 patients with low MUC4 expression (<20% of neoplastic cells stained) (p  =  0.0043). Univariate analysis showed that high MUC4 expression (p  =  0.0061), large primary tumour status (>T2) (p  =  0.0436), distant metastasis (p  =  0.0383), lymphatic invasion (p  =  0.0243), and surgical margins (p  =  0.0333) were significant risk factors affecting the outcome of patients with IDC. Backward stepwise multivariate analysis showed that MUC4 expression (p  =  0.0121), lymph node metastasis (p  =  0.0245), and lymphatic invasion (p  =  0.0239) were significant independent risk factors. ErbB2, p27, and MUC1 were not independent risk factors.

Conclusions: This study shows that MUC4 expression in IDC is a new independent factor for poor prognosis and predicts the outcome of patients with IDC.

  • ABC, avidin–biotinylated horseradish peroxidase complex
  • CI, confidence interval
  • HR, hazard ratio
  • ICC-MF, intrahepatic cholangiocarcinoma mass forming type
  • IDC, invasive ductal carcinoma of the pancreas
  • PanIN, pancreatic intraepithelial neoplasia
  • PBS, phosphate buffered saline
  • SMC, sialomucin complex
  • pancreatic cancer
  • mucin
  • immunohistochemistry
  • cumulative survival rate
  • multivariate analysis

https://doi.org/10.1136/jcp.2004.023572

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