title: Mucin expression in endoscopic ultrasound-guided fine-needle aspiration specimens is a useful prognostic factor in pancreatic ductal adenocarcinoma.
abstract: OBJECTIVE
  The aim of this study was to further examine the utility of mucin (MUC) expression profiles as prognostic factors in pancreatic ductal adenocarcinoma (PDAC).
  
  
  METHODS
  Mucin expression was examined by immunohistochemistry analysis in endoscopic ultrasound-guided fine-needle aspiration specimens obtained from 114 patients with PDAC. The rate of expression of each MUC was compared with clinicopathologic features.
  
  
  RESULTS
  The expression rates of MUCs in cancer lesions were MUC1, 87.7%; MUC2, 0.8%; MUC4, 93.0%; MUC5AC, 78.9%; MUC6, 24.6%; and MUC16, 67.5%. MUC1 and MUC4 were positive, and MUC2 was negative in most PDACs. Patients with advanced stage of PDAC with MUC5AC expression had a significantly better outcome than those who were MUC5AC-negative (P = 0.002). With increasing clinical stage, total MUC6 expression decreased (P for trend = 0.001) and MUC16 cytoplasmic expression increased (P for trend = 0.02). The prognosis of patients with MUC16 cytoplasmic expression was significantly poorer than those without this expression. Multivariate survival analysis revealed that MUC16 cytoplasmic expression was a significant independent predictor of a poor prognosis after adjusting for the effects of other prognostic factors (P = 0.002).
  
  
  CONCLUSIONS
  Mucin expression profiles in ultrasound-guided fine-needle aspiration specimens have excellent diagnostic utility and are useful predictors of outcome in patients with PDAC.
authors.affiliation: From the *Department of Human Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences; †National Sanatorium Hoshizuka-Keiaien, Kanoya; ‡Department of Digestive and Lifestyle Diseases, §Department of Radiology, ∥Department of Epidemiology and Preventive Medicine, ¶Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; and #Department of Biochemistry and Molecular Biology, Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Michiyo
authors.initials: M
authors.lastname: Higashi
authors.forename: Seiya
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yuko
authors.initials: Y
authors.lastname: Goto
authors.forename: Ikumi
authors.initials: I
authors.lastname: Kitazono
authors.forename: Tsubasa
authors.initials: T
authors.lastname: Hiraki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Taguchi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Fukukura
authors.forename: Chihaya
authors.initials: C
authors.lastname: Koriyama
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mataki
authors.forename: Kosei
authors.initials: K
authors.lastname: Maemura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shinchi
authors.forename: Maneesh
authors.initials: M
authors.lastname: Jain
authors.forename: Surinder K
authors.initials: SK
authors.lastname: Batra
authors.forename: Suguru
authors.initials: S
authors.lastname: Yonezawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D021441:Carcinoma, Pancreatic Ductal / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016009:Chi-Square Distribution; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000032:analysis*; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D009077:Mucins