Abstract
Pancreatic cancer is the fourth cause of cancer deaths in the U.S. with most patients diagnosed at advanced stages followed by short survival. Therefore, biomarkers for early detection are urgently needed. Mucin 4 (MUC4) is a mucin protein encoded by the MUC4 gene and identified in the majority of pancreatic cancers. With increasing clinical identification and diagnosis of pancreatic cysts globally and transformation of some cysts into pancreatic cancer, it is important to evaluate if MUC4 is expressed in pancreatic cysts.Immunohistochemistry assays utilizing heat-induced epitope retrieval (HIER) were performed to examine MUC4 protein expression in 44 paraffin-embedded tissues of pancreatic cancers and 20 pancreatic cysts. All patients were diagnosed and operated upon at the Mansoura University Gastrointestinal Surgery Center in Egypt. Clinical, demographic, and survival information were abstracted from the patients’ medical records. Logistic regression was performed to predict expression of MUC4 protein in cancer and cysts, by type of cysts.Pancreatic cyst patients were significantly younger than pancreatic cancer patients (Mean age of 28.7 ± 5.25 vs. 54.84 ± 10.60 years) (p=0.0001). Expression of MUC4 was not different between cancers and pancreatic cysts (p=0.16). However, type of pancreatic cysts was predictive of MUC4 expression. Mucinous cystic neoplasms and serous cystadenoma cysts showed significantly higher MUC4 expression than non-specified and pseudocysts (80%, 75%, 25%, and 0% expression for the 4 types of cysts, respectively) (p=0.022).MUC4 expression may be associated with certain types of cysts. Follow-up of pancreatic cyst patients who show MUC4 expression might reveal clues to early detection of pancreatic cancer.
Highlights
Pancreatic Cancer is one of the short-survival cancers with one-year relative survival rate of approximately 29%, and the five-year rate of about 7% in the U.S [1,2]
Mucinous cystic neoplasms and serous cystadenoma cysts showed significantly higher Mucin 4 (MUC4) expression than non-specified and pseudocysts (80%, 75%, 25%, and 0% expression for the 4 types of cysts, respectively) (p=0.022)
59.9% of pancreatic cancer patients lived in rural area while 80% of the pancreatic cyst patients lived in rural areas (p=0.2615)
Summary
Pancreatic Cancer is one of the short-survival cancers with one-year relative survival rate of approximately 29%, and the five-year rate of about 7% in the U.S [1,2]. Pancreatic cancer is the 19th most common cancer in Africa [3] and is not one of the common cancers in Egypt. Pancreatic cancer in Egypt occurs at a relatively young age of diagnosis [6] and is more common in polluted regions [7], and shows variation in mutations by place of residence in relation to pollution levels in the country [8,9]. Mucins are high molecular weight glycoproteins that play a protective function for the epithelial cells under normal physiological conditions. MUC4 is membrane-bound mucin that is overexpressed in pancreatic cancer but absent in normal pancreas and chronic pancreatitis [11]
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