İlhan Özgür, Han Ünsal, Önal Binnur, Çelık Serkan Yaşar
Department of Pathology and Cytology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara.
Turk J Gastroenterol. 2010 Dec;21(4):345-52. doi: 10.4318/tjg.2010.0119.
BACKGROUND/AIMS: The aim of this study was to investigate the expressions of some of the Mucus Core Proteins (MUC) MUC1, MUC2 and MUC5AC in gastric carcinomas, to assess their prognostic values and their relations with the clinicopathological characteristics.
MUC1, MUC2 and MUC5AC expressions were investigated immunohistochemically in 257 patients with gastric carcinomas.
MUC1 was strongly expressed in normal gastric epithelium; however, the expression rate decreased with the loss of tumor differentiation (92.6% in well differentiated tumors, 83.7% in poorly differentiated tumors), with an increase in the number of metastatic lymph nodes (98.4% in tumors with no metastatic lymph nodes, 67.9% in tumors with lymph node metastasis-pN3), and with the progression in the tumor stage (100% in stage 1 tumors, 75.6% in stage 4 tumors). MUC1 expression was lower in distant metastatic tumors (83.3% in distant metastatic tumors and 90.8% in nonmetastatic tumors). There was no staining with MUC2 in normal gastric epithelium; however, de novo expressions appeared in tumoral tissues. In diffuse gastric carcinomas (mucinous and signet ring cell carcinomas), MUC2 expression was higher (97.5% in diffuse type and 89.4% in intestinal type). All of the mucinous carcinomas were MUC2-positive. The expression rate decreased with an increase in the number of metastatic lymph nodes and with the progression in the TNM stages of the cases. All of the tumors with intestinal metaplasia were MUC2-positive. MUC5AC was strongly expressed in normal gastric epithelium; however, the expression rate decreased with the loss of tumor differentiation, with an increase in the tumor invasion depth, and with an increase in the number of metastatic lymph nodes. MUC5AC expression was higher in intestinal type carcinoma (48.4%) than in the diffuse type (10%). The lowest expression rate was in the diffuse type according to the Borrmann's macroscopic classification. All of these results were statistically significant (p<0.05).
When each of these three markers is evaluated, in the light of clinical and pathological parameters, MUC1 and MUC5AC may be accepted as significant prognostic parameters and may be useful in showing the progression of the tumors; MUC2 may be used in determining the mucinous carcinomas.
背景/目的：本研究旨在调查一些黏液核心蛋白（MUC）MUC1、MUC2和MUC5AC在胃癌中的表达，评估其预后价值以及它们与临床病理特征的关系。
采用免疫组织化学方法检测257例胃癌患者的MUC1、MUC2和MUC5AC表达。
MUC1在正常胃上皮中强表达；然而，随着肿瘤分化程度降低，其表达率下降（高分化肿瘤中为92.6%，低分化肿瘤中为83.7%），随着转移淋巴结数量增加，其表达率下降（无转移淋巴结的肿瘤中为98.4%，有淋巴结转移-pN3的肿瘤中为67.9%），随着肿瘤分期进展，其表达率下降（I期肿瘤中为100%，IV期肿瘤中为75.6%）。远处转移肿瘤中MUC1表达较低（远处转移肿瘤中为83.3%，非转移肿瘤中为90.8%）。正常胃上皮中无MUC2染色；然而，肿瘤组织中出现了新生表达。在弥漫性胃癌（黏液性癌和印戒细胞癌）中，MUC2表达较高（弥漫型中为97.5%，肠型中为89.4%）。所有黏液性癌均为MUC2阳性。随着转移淋巴结数量增加和病例TNM分期进展，表达率下降。所有肠化生的肿瘤均为MUC2阳性。MUC5AC在正常胃上皮中强表达；然而，随着肿瘤分化程度降低、肿瘤浸润深度增加以及转移淋巴结数量增加，其表达率下降。MUC5AC在肠型癌（48.4%）中的表达高于弥漫型（10%）。根据Borrmann大体分类，弥漫型的表达率最低。所有这些结果均具有统计学意义（p<0.05）。
当根据临床和病理参数评估这三种标志物中的每一种时，MUC1和MUC5AC可被视为重要的预后参数，可能有助于显示肿瘤的进展；MUC2可用于确定黏液性癌。
