title: Lack of mucin MUC5AC field change expression associated with tubulovillous and villous colorectal adenomas.
abstract: BACKGROUND
  MUC5AC is a secreted mucin aberrantly expressed by polypoid colorectal adenomas. It has been hypothesised that the "normal" surrounding colorectal mucosa expresses MUC5AC as a field change phenomenon that can be used to predict adenoma recurrence following resection.
  
  
  OBJECTIVE
  To determine if there is a field change of de novo MUC5AC expression in histologically normal rectal mucosa adjacent to villous and tubulovillous adenomas, and thus whether MUC5AC expression can be used as a marker of early tumour recurrence.
  
  
  METHODS
  In a prospective cohort study paired mucosal biopsies of adenomatous and macroscopically "normal" mucosa were obtained from 11 patients with villous and 11 patients with tubulovillous adenomas who underwent primary resection for purpose of cure. The tissues were studied to determine MUC5AC gene expression by immunohistochemistry and in situ hybridisation. Patients were followed up by flexible sigmoidoscopy to detect the presence of early local recurrence.
  
  
  RESULTS
  10 villous adenomas showed mature MUC5AC glycoprotein and all 11 expressed MUC5AC mRNA. Five tubulovillous adenomas showed mature MUC5AC glycoprotein and 10 expressed MUC5AC mRNA. Neoexpression of the MUC5AC mucin gene was not detected in any of the mucosal biopsies taken adjacent to either villous or tubulovillous adenomas, even in three patients with early, locally recurrent disease.
  
  
  CONCLUSIONS
  Aberrant MUC5AC gene expression is not a "field change" in the colorectal mucosa in patients with rectal adenomas and therefore cannot be used to predict local recurrence of villous and tubulovillous adenomas.
authors.affiliation: University Department of Surgery, Bristol Royal Infirmary, UK. Rob.Longman@bristol.ac.uk
authors.forename: R J
authors.initials: RJ
authors.lastname: Longman
authors.forename: J
authors.initials: J
authors.lastname: Douthwaite
authors.forename: P A
authors.initials: PA
authors.lastname: Sylvester
authors.forename: D
authors.initials: D
authors.lastname: O'Leary
authors.forename: B F
authors.initials: BF
authors.lastname: Warren
authors.forename: A P
authors.initials: AP
authors.lastname: Corfield
authors.forename: M G
authors.initials: MG
authors.lastname: Thomas
mesh_terms: D018253:Adenoma, Villous / Q000175:diagnosis / Q000378:metabolism* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D017403:In Situ Hybridization; D007413:Intestinal Mucosa / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D055271:Mucin 5AC; D009077:Mucins / Q000378:metabolism*; D009363:Neoplasm Proteins / Q000378:metabolism*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D011446:Prospective Studies; D012007:Rectum / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; C524678:MUC5AC protein, human; D055271:Mucin 5AC; D009077:Mucins; D009363:Neoplasm Proteins