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. 2026 Jan-Feb;39(1):48-53.
doi: 10.20524/aog.2026.1021. Epub 2025 Dec 5.

MUC1 as a biomarker in primary sclerosing cholangitis and cholangiocarcinoma

Jana G Hashash  1   2 , Pamela Beatty  3 , Irene K Yan  4   5 , Raouf Nakhleh  6 , Micheal Camilleri  7 , Denise Harnois  5 , Francis A Farraye  1 , Fadi F Francis  1   2
Affiliations

MUC1 as a biomarker in primary sclerosing cholangitis and cholangiocarcinoma

Jana G Hashash et al. Ann Gastroenterol. 2026 Jan-Feb.

Abstract

Background: MUC1 is a glycoprotein expressed at low levels in fully glycosylated form on healthy epithelial cells. In inflammation and malignancy, MUC1 becomes overexpressed and hypoglycosylated. We aimed to describe patterns of MUC1 expression in bile-duct tissue of patients with primary sclerosing cholangitis (PSC), PSC/cholangiocarcinoma, cholangiocarcinoma, and healthy controls.

Methods: In this proof-of-concept pilot study, archived human liver tissue samples were identified and stained using anti-MUC1 antibodies. Staining for all MUC1, and specifically hypoglycosylated MUC1, was performed.

Results: Tissue from controls minimally expressed the hypoglycosylated/abnormal MUC1. Tissue from patients with PSC demonstrated moderate expression. Very high levels were expressed in sporadic cholangiocarcinoma.

Conclusion: MUC1 may serve as a biomarker in the identification of bile-duct disease and cancer.

Keywords: MUC1; bile ducts; biomarker; cholangiocarcinoma; primary sclerosing cholangitis.

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Conflict of interest statement

Conflicts of Interest: Jana G. Hashash has served on an Advisory Board for BMS (ended). Francis A. Farraye has consulting fees from: Astellas, Avalo Therapeutics, Bausch, BMS, Braintree Labs, Fresenius Kabi, GI Reviewers, GSK, IBD Educational Group, Iterative Health, Janssen, Pharmacosmos, Pfizer, Sandoz Immunology, Viatris. DSMB: Eli Lilly. The rest of the authors have no relevant financial or non-financial interests to disclose

Figures

Figure 1
Figure 1
Total MUC1 expression score of abnormal hypoglycosylated MUC1 on bile-duct epithelial tissue of patients with normal bile ducts, those with PSC, PSC and concomitant cholangiocarcinoma, and sporadic cholangiocarcinoma, using 4H5 antibody, which stains the hypoglycosylated (abnormal) form of MUC1. Each dot represents a single patient PSC, primary sclerosing cholangitis; CCA, cholangiocarcinoma
Figure 2
Figure 2
Expression of hypoglycosylated MUC1 and all MUC1 on bile-duct epithelial tissue using 4H5 and HMPV antibody, respectively PSC, primary sclerosing cholangitis; CCA, cholangiocarcinoma
Figure 3
Figure 3
Total MUC1 expression score of total MUC1 (normal and abnormal) on bile-duct epithelial tissue of patients with normal bile ducts, those with PSC, PSC and concomitant cholangiocarcinoma, and sporadic cholangiocarcinoma, using HMPV antibody, which stains all forms of MUC1. Each dot represents a single patient PSC, primary sclerosing cholangitis; CCA, cholangiocarcinoma
See this image and copyright information in PMC

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