title: Low MUC4 expression is associated with survival benefit in patients with resectable pancreatic cancer receiving adjuvant gemcitabine.
abstract: BACKGROUND
  Previous in vitro studies have shown that mucin 4 (MUC4) confers resistance toward gemcitabine in pancreatic cancer cells. To date, there are few clinical studies corroborating these findings. The aim of this study was to evaluate the predictive impact of MUC4 expression on survival in patients with resectable pancreatic cancer receiving adjuvant gemcitabine.
  
  
  METHODS
  MUC4 expression was investigated by immunohistochemistry in 78 tissue sections from patients with pancreatic ductal adenocarcinoma undergoing Whipple resection. The H-score was used to evaluate MUC4 expression. The Kaplan-Meier method and Cox proportional hazards regression analysis were used to assess the predictive role of MUC4 expression.
  
  
  RESULTS
  The MUC4 protein was expressed in 93.6% (73/78) of pancreatic cancer tissue specimens. None of the normal control pancreatic tissues had any MUC4 expression. Low MUC4 expression (H-score ≤100) was detectable in 42 (53.8%) of tumors and high MUC4 expression (H-score >100) was detectable in 36 (46.2%) of tumors. Low expression of MUC4 was associated with favorable survival (p = .027), whereas high MUC4 expression did not correlate with survival (p = .87) in patients receiving adjuvant gemcitabine treatment.
  
  
  CONCLUSIONS
  This is the first study indicating a predictive role of MUC4 expression for gemcitabine treatment in the clinical setting.
authors.affiliation: a Department of Surgery , Clinical Sciences Lund, Skåne University Hospital, Lund University , Lund , Sweden.
authors.forename: Carlos
authors.initials: C
authors.lastname: Urey
authors.affiliation: a Department of Surgery , Clinical Sciences Lund, Skåne University Hospital, Lund University , Lund , Sweden.
authors.forename: Bodil
authors.initials: B
authors.lastname: Andersson
authors.affiliation: a Department of Surgery , Clinical Sciences Lund, Skåne University Hospital, Lund University , Lund , Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ansari
authors.affiliation: b Department of Pathology , Skåne University Hospital, Lund University , Lund , Sweden.
authors.forename: Agata
authors.initials: A
authors.lastname: Sasor
authors.affiliation: a Department of Surgery , Clinical Sciences Lund, Skåne University Hospital, Lund University , Lund , Sweden.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Said-Hilmersson
authors.affiliation: c Department of Cardiothoracic Surgery, Clinical Sciences Lund , Skåne University Hospital, Lund University , Lund , Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Nilsson
authors.affiliation: a Department of Surgery , Clinical Sciences Lund, Skåne University Hospital, Lund University , Lund , Sweden.
authors.forename: Roland
authors.initials: R
authors.lastname: Andersson
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D021441:Carcinoma, Pancreatic Ductal / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D055264:Mucin-4 / Q000235:genetics / Q000378:metabolism*; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D016019:Survival Analysis; D013548:Sweden; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; C524658:MUC4 protein, human; D055264:Mucin-4; D003841:Deoxycytidine; D000093542:Gemcitabine
keywords: MUC4; Pancreatic ductal adenocarcinoma; gemcitabine; immunohistochemistry; mucins