A novel serum marker for biliary tract cancer: diagnostic and prognostic values of quantitative evaluation of serum mucin 5AC (MUC5AC).
OBJECTIVE
Mucin 5AC (MUC5AC) is a glycoprotein found in different epithelial cancers, including biliary tract cancer (BTC). The aims of this study were to investigate the role of MUC5AC as serum marker for BTC and its prognostic value after operation with curative intent.


METHODS
From January 2007 to July 2012, a quantitative assessment of serum MUC5AC was performed with enzyme-linked immunoassay in a total of 88 subjects. Clinical and biochemical data (including CEA and Ca 19-9) of 49 patients with BTC were compared with a control population that included 23 patients with benign biliary disease (BBD) and 16 healthy control subjects (HCS).


RESULTS
Serum MUC5AC was greater in BTC patients (mean 17.93 ± 10.39 ng/mL) compared with BBD (mean 5.95 ± 5.39 ng/mL; P < .01) and HCS (mean 2.74 ± 1.35 ng/mL) (P < .01). Multivariate analysis showed that MUC5AC was related with the presence of BTC compared with Ca 19-9 and CEA: P < .01, P = .080, and P = .463, respectively. In the BTC group, serum MUC5AC ≥ 14 ng/mL was associated with lymph-node metastasis (P = .050) and American Joint Committee on Cancer and International Union for Cancer Control stage IVb disease (P = .047). Moreover, in patients who underwent operation with curative intent, serum MUC5AC ≥ 14 ng/mL was related to a worse prognosis compared with patients with lesser levels, with 3-year survival rates of 21.5% and 59.3%, respectively (P = .039).


CONCLUSIONS
MUC5AC could be proposed as new serum marker for BTC. Moreover, the quantitative assessment of serum MUC5AC could be related to tumor stage and long-term survival in patients with BTC undergoing operation with curative intent.
Department of Surgery, Division of General Surgery "A," Unit of Hepato Pancreato Biliary Surgery, Verona, Italy.
Andrea
A
Ruzzenente
Department of Surgery, Division of General Surgery "A," Unit of Hepato Pancreato Biliary Surgery, Verona, Italy. Electronic address: calogero.iacono@univr.it.
Calogero
C
Iacono
Department of Surgery, Division of General Surgery "A," Unit of Hepato Pancreato Biliary Surgery, Verona, Italy.
Simone
S
Conci
Department of Surgery, Division of General Surgery "A," Unit of Hepato Pancreato Biliary Surgery, Verona, Italy.
Francesca
F
Bertuzzo
Department of Life and Reproduction Sciences, Division of Clinical Biochemistry, GB Rossi University Hospital, University of Verona, Verona, Italy.
Gianluca
G
Salvagno
Department of Life and Reproduction Sciences, Division of Clinical Biochemistry, GB Rossi University Hospital, University of Verona, Verona, Italy.
Orazio
O
Ruzzenente
Department of Surgery, Division of General Surgery "A," Unit of Hepato Pancreato Biliary Surgery, Verona, Italy.
Tommaso
T
Campagnaro
Department of Surgery, Division of General Surgery "A," Unit of Hepato Pancreato Biliary Surgery, Verona, Italy.
Alessandro
A
Valdegamberi
Department of Surgery, Division of General Surgery "A," Unit of Hepato Pancreato Biliary Surgery, Verona, Italy.
Silvia
S
Pachera
Department of Surgery, Division of General Surgery "A," Unit of Hepato Pancreato Biliary Surgery, Verona, Italy.
Fabio
F
Bagante
Department of Surgery, Division of General Surgery "A," Unit of Hepato Pancreato Biliary Surgery, Verona, Italy.
Alfredo
A
Guglielmi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D018281:Cholangiocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055271:Mucin 5AC / Q000097:blood*; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D015996:Survival Rate
D014408:Biomarkers, Tumor; C524678:MUC5AC protein, human; D055271:Mucin 5AC