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. 2006 Jan 12:6:4.
doi: 10.1186/1471-230X-6-4.

Humoral immune response to MUC5AC in patients with colorectal polyps and colorectal carcinoma

Belma Kocer  1 , John McKolanis, Atilla Soran
Affiliations

Humoral immune response to MUC5AC in patients with colorectal polyps and colorectal carcinoma

Belma Kocer et al. BMC Gastroenterol. .

Abstract

Background: MUC5AC is a secreted mucin aberrantly expressed by colorectal polyps and carcinoma. It has been hypothesized that aberrant expression of MUC5AC in colorectal carcinoma tissues increased the overall survival of patients with colorectal carcinoma. The present study investigates the incidence of naturally occurring MUC5AC antibodies in the sera of normal individuals, patients with colonic polyps and patients with advanced colorectal carcinoma. A second aim was to determine the relationship of MUC5AC antibody with the prognosis of colorectal carcinoma.

Methods: Free circulating MUC5AC antibodies were measured using an enzyme-linked immunosorbent assay with a synthetic peptide corresponding to an 8 aa. segment of MUC5AC tandem repeat region. Immunohistochemical analysis was completed to demonstrate MUC5AC expression in the polyp specimens.

Results: MUC5AC antibodies were detected in 6 of 22 (27.3%) healthy subjects, 9 of 20 (45%) polyp patients, 18 of 30 (60%) patients with colorectal cancer. The presence of circulating free MUC5AC antibody levels was significantly correlated with expression of MUC5AC in polyp sections. Serum MUC5AC antibody positivity was higher in patients with colon located tumors, advanced stage and poorly differentiated tumors were found negatively affecting patient survival in our study. MUC5AC antibody positivity was higher in patients with poor prognostic parameters. Disease free survival and overall survival were shorter in this group of patients. In the multivariate analysis MUC5AC antibody positivity didn't find an independent prognostic factor on prognosis.

Conclusion: Decreased survival in colorectal carcinoma patients with MUC5AC antibody positivity may be due to a decrease in the MUC5AC expression in tumor tissues of surviving carcinoma patients.

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Figures

Figure 1
Figure 1
The ROC curve-comparing controls with colorectal carcinoma and polyp patients shows 0.618 of validity. ROC = receiving operating characterizing. The cut off level was taken as OD 0.225. At this value maximal sensitivity 54% and specificity 73% were attained.
Figure 2
Figure 2
Incidence of circulating MUC5AC antibody in sera of healthy subjects, polyps, and colorectal carcinoma. As an arbitrary cut-off level 0,225 OD units was chosen. OD: Optical density.
Figure 3
Figure 3
Survival curve of the colorectal tumor patients with MUC5AC antibody positive and MUC5AC antibody negative determined by the Kaplan Meier method. MUC5AC antibody positive patients showed significantly worse survival than those with MUC5AC antibody negative patients (p = 0.052). Cum Survival = Probability of cumulative survival. OVS = Overall survival.
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