title: Inverse effects of mucin on survival of matched hereditary nonpolyposis colorectal cancer and sporadic colorectal cancer patients.
abstract: OBJECTIVE
  To compare survival and histologic features of hereditary nonpolyposis colorectal cancer (HNPCC; Lynch syndrome) cases to well-matched sporadic colon cancers from the same patient population.
  
  
  METHODS
  Between January 1995 and March 2002, a total of 5,138 consecutive patients underwent resection of primary colorectal adenocarcinoma in a single institution. According to the Amsterdam criteria, 56 HNPCC patients were matched to 147 sporadic colorectal cancer (SCRC) with no family history of cancer and with the same gender, tumor location, and age within 3 years. Immunohistochemical analyses were done for MUC1, MUC2, MUC3, and MUC5AC.
  
  
  RESULTS
  The HNPCC group had a marginally significantly better long-term outcome than the SCRC group (P = 0.058). The trend disappeared after adjustment by tumor-node-metastasis stage in a Cox model (P = 0.774). We noted a difference of >50% in the 5-year cancer-specific survival rates of HNPCC- and SCRC-mucinous groups (92% versus 31%, P = 0.0003). Interaction between mucin and HNPCC and its effects on survival were further confirmed by comparing the Cox models with and without interaction terms (hazard ratio, 0.1; P = 0.034 with adjusting stage). Patients with tumors showing dual expression of mucin and MUC1, which appeared in 11% of those with HNPCC and 50% of those with SCRC, had a lower 5-year cancer-specific survival rate than patients without (30% versus 60%; P = 0.004 by log-rank test; P = 0.039 with adjustment for tumor-node-metastasis stage).
  
  
  CONCLUSIONS
  These results suggest that mucin has an inverse effect on survival in patients with HNPCC and SCRC, which might be partly explained by a lower prevalence of MUC1 expression in the mucinous HNPCC group than in the SCRC groups.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine at Linko, Taiwan.
authors.forename: Jeng-Fu
authors.initials: JF
authors.lastname: You
authors.forename: Ling-Ling
authors.initials: LL
authors.lastname: Hsieh
authors.forename: Chung Rong
authors.initials: CR
authors.lastname: Changchien
authors.forename: Jinn-Shiun
authors.initials: JS
authors.lastname: Chen
authors.forename: Jim-Ray
authors.initials: JR
authors.lastname: Chen
authors.forename: Jy-Ming
authors.initials: JM
authors.lastname: Chiang
authors.forename: Chien Yuh
authors.initials: CY
authors.lastname: Yeh
authors.forename: Pao-Shiu
authors.initials: PS
authors.lastname: Hsieh
authors.forename: Chung-Wei
authors.initials: CW
authors.lastname: Fan
authors.forename: Chun-Ting
authors.initials: CT
authors.lastname: Liu
authors.forename: Reiping
authors.initials: R
authors.lastname: Tang
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000401:mortality; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000378:metabolism* / Q000401:mortality; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000096:biosynthesis*; D009077:Mucins / Q000096:biosynthesis / Q000502:physiology*; D016016:Proportional Hazards Models; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D018396:Mucin-1; D009077:Mucins