title: MUC-1 expression as a predictor of the curative endoscopic treatment of submucosally invasive colorectal carcinoma.
abstract: OBJECTIVE
  This study was undertaken to clarify the clinical significance of MUC-1 expression in the endoscopic treatment of colorectal carcinoma with submucosal invasion.
  
  
  METHODS
  One hundred eighty-four colorectal carcinomas with submucosal invasion were examined. The depth of submucosal invasion was classified as scanty or massive. The histologic subclassification at the deepest invasive portion was defined as well-differentiated, moderately well-differentiated, moderately to poorly differentiated, poorly differentiated, or mucinous adenocarcinoma. MUC-1 expression was examined immunohistochemically at the deepest invasive portion. In addition, the Ki67 labeling index was also examined immunohistochemically.
  
  
  RESULTS
  Lymph node metastases were detected in 28 (15.2 percent) of 184 lesions. Lesions with both scanty submucosal invasion and well-differentiated or moderately well-differentiated adenocarcinomas had no lymph node metastases. MUC-1 expression was detected in 88 (47.8 percent) of 184 lesions and correlated significantly with the presence of lymph node metastases. The Ki67 labeling index also correlated significantly with lymph node metastases. Furthermore, lesions with both MUC-1-negative and low Ki67 labeling index showed no lymph node metastases, even in lesions with massive submucosal invasion. Multivariate analysis indicated that MUC-1 expression was one of the most important risk factors for lymph node metastases and histologic grade among the clinicopathologic factors usually examined.
  
  
  CONCLUSIONS
  MUC-1 expression is one of the accurate predictors of the presence of lymph node metastases among the clinicopathologic factors commonly used. Combined analysis of MUC-1 expression and Ki67 labeling index may be a useful indicator of lymph node metastases and may broaden the indications for the curative endoscopic treatment of carcinoma with massive submucosal invasion.
authors.affiliation: First Department of Internal Medicine, Hiroshima University School of Medicine, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Aoki
authors.forename: S
authors.initials: S
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Haruma
authors.forename: M
authors.initials: M
authors.lastname: Yoshihara
authors.forename: K
authors.initials: K
authors.lastname: Sumii
authors.forename: G
authors.initials: G
authors.lastname: Kajiyama
authors.forename: F
authors.initials: F
authors.lastname: Shimamoto
authors.forename: N
authors.initials: N
authors.lastname: Kohno
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*; D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D000911:Antibodies, Monoclonal; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008207:Lymphatic Metastasis; D018396:Mucin-1 / Q000032:analysis*; D009361:Neoplasm Invasiveness
chemical_list: D000911:Antibodies, Monoclonal; D019394:Ki-67 Antigen; D018396:Mucin-1