Abstract
The practical use of knowledge on the diagnostic-prognostic role of polysaccharide components of mucins in colorectal cancer (CRC) has been difficult, due to the number of histochemical (HC) reaction types, as well as lack of standard methods of computer-assisted analysis of tissue expression of these molecules. Using two algorithms of digital image analysis (by application of Image-Pro Premier and our originally designed program Filter HSV), we evaluated the expression of polysaccharides in tissue samples of CRC patients (n = 33), and fragments of normal colorectal tissue from the same patients (control) using periodic acid Schiff reaction (PAS) (neutral mucins) and alcian blue staining (AB) (acidic mucins). Our results indicate lower expression of the PAS+ and AB+ mucins in CRC, as compared to the control samples. The higher expression of PAS+ polysaccharides was detected in flat tumors than in protruded CRC, while higher AB+ mucins expression was a feature of mucinous CRC subtypes. Positive correlation between mutual PAS+ and AB+ expression, as well as correlations with glucose concentration (PAS+ mucins), and hemoglobin level (AB+ mucins) were observed exclusively in unchanged colorectal samples (control). Both algorithms of digital image analysis (smart segmentation and Filter HSV) work properly and can be used interchangeably in daily practice of pathologists, as useful tools of quantitative evaluation of HC reaction in both normal and cancerous tissues.
Highlights
Colorectal carcinoma (CRC) is the third cancer in terms of incidence and second in terms of mortality [1]
CRC is characterized by high inter-patient and intra-tumor heterogeneity, as well as temporal molecular heterogeneity during treatment, which is known to influence the response to therapy and prognosis [3]
Some studies suggest that the aberrant and deregulated expression of mucins represent a link between cancer and inflammation [9]
Summary
Colorectal carcinoma (CRC) is the third cancer in terms of incidence and second in terms of mortality [1]. While genetic and epigenetic mechanisms are important and quite well described in colorectal carcinogenesis, the basis of the most cases of cancer is unknown. A small subset of CRC cases (up to 3%) arises as a consequence of inflammatory bowel diseases [4]. Both in histologically normal and morphologically changed colon, quantitative and qualitative changes in mucin polysaccharides were described for a few decades [5,6,7,8]. Some studies suggest that the aberrant and deregulated expression of mucins represent a link between cancer and inflammation [9]
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