title: Mucins and CD56 as markers of tumour invasion and prognosis in periampullary cancer.
abstract: BACKGROUND
  This study investigated the association of mucins and cluster of differentiation (CD) 56 with vascular and perineural invasion and survival in patients with periampullary cancer.
  
  
  METHODS
  Immunohistochemical staining was performed on formalin-fixed pancreatic tissue microarrays (cancer, chronic pancreatitis and normal pancreatic tissue) constructed from 126 pancreatic resections (cancer, 104; chronic pancreatitis, 22). Mucin (MUC) 1, MUC4 and MUC5AC expression was quantified using the immunohistochemical score (range 0-300), MUC3 expression was described as membranous or cytoplasmic, and expression of CD56, MUC2 and MUC6 as present or absent.
  
  
  RESULTS
  In cancers, vascular invasion correlated with overexpression (immunohistochemical score of 100 or more) of MUC1 (P = 0.003) and presence of MUC6 (P = 0.024), and perineural invasion correlated with overexpression of MUC5AC (P = 0.015). Reduced survival was observed with overexpression of MUC4 (P = 0.032) and MUC5AC (P = 0.048), membranous expression of MUC3 (P = 0.048), and presence of CD56 (P = 0.041). Perineural invasion also correlated with CD56 expression (P = 0.001). Overexpression of MUC4 and MUC5AC correlated with tumour recurrence (P = 0.001 and P = 0.034 respectively). Multivariable analysis identified membranous expression of MUC3 (P = 0.023), lymphatic invasion (P = 0.015) and perineural invasion (P = 0.004) as independent predictors of poor survival.
  
  
  CONCLUSIONS
  Mucins and CD56 may be markers of prognosis in patients with periampullary cancer.
authors.affiliation: Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK.
authors.forename: M M
authors.initials: MM
authors.lastname: Aloysius
authors.forename: A M
authors.initials: AM
authors.lastname: Zaitoun
authors.forename: S
authors.initials: S
authors.lastname: Awad
authors.forename: M
authors.initials: M
authors.lastname: Ilyas
authors.forename: B J
authors.initials: BJ
authors.lastname: Rowlands
authors.forename: D N
authors.initials: DN
authors.lastname: Lobo
mesh_terms: D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism*; D019002:CD56 Antigen / Q000378:metabolism*; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism*; D009361:Neoplasm Invasiveness; D050500:Pancreatitis, Chronic / Q000175:diagnosis; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; D019002:CD56 Antigen; D009077:Mucins