Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 7, 2021; 27(25): 3888-3900
Published online Jul 7, 2021. doi: 10.3748/wjg.v27.i25.3888
Diverse expression patterns of mucin 2 in colorectal cancer indicates its mechanism related to the intestinal mucosal barrier
Guo-Lian Gan, Hua-Tao Wu, Wen-Jia Chen, Chun-Lan Li, Qian-Qian Ye, Yi-Feng Zheng, Jing Liu
Guo-Lian Gan, Hua-Tao Wu, Yi-Feng Zheng, Department of General Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Wen-Jia Chen, Chun-Lan Li, Qian-Qian Ye, Jing Liu, Changjiang Scholar’s Laboratory, Shantou University Medical College, Shantou 515041, Guangdong Province, China
Wen-Jia Chen, Chun-Lan Li, Qian-Qian Ye, Jing Liu, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Breast Cancer, Shantou University Medical College, Shantou 515041, Guangdong Province, China
Wen-Jia Chen, Chun-Lan Li, Qian-Qian Ye, Jing Liu, Department of Physiology, Shantou University Medical College, Shantou 515041, Guangdong Province, China
Author contributions: Liu J and Zheng YF contributed to the conception and design of the study; Gan GL and Wu HT performed most of the experiments, analyzed the data, and drafted and revised the manuscript carefully; Chen WJ, Li CL, Ye QQ, and Zheng YF performed some of the experiments and interpreted the data; Wu HT, Zheng YF, and Liu J provided essential reagents; Liu J assisted with the experimental design and data analysis, and revised the original manuscript critically; all authors contributed to manuscript revision, and read and approved the submitted version.
Supported by National Natural Science Foundation of China, No. 81501539; the Natural Science Foundation of Guangdong Province, China, No. 2016A030312008; Science and Technology Planning Project of Shantou, China, No. 200617105260368; Medical Scientific Research Foundation of Guangdong, China, No. A2020627; and “Dengfeng Project” for the Construction of High-level Hospital in Guangdong Province—The First Affiliated Hospital of Shantou University College Supporting Funding, No. 202003-10.
Institutional review board statement: The current study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Shantou University Medical College.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: No conflict of interest is claimed by any author.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Liu, MD, PhD, Associate Professor, Changjiang Scholar’s Laboratory, Shantou University Medical College, No. 22 Xinling Road, Shantou 515041, Guangdong Province, China. jliu12@stu.edu.cn
Received: January 29, 2021
Peer-review started: January 29, 2021
First decision: February 25, 2021
Revised: March 11, 2021
Accepted: June 4, 2021
Article in press: June 4, 2021
Published online: July 7, 2021
Processing time: 157 Days and 23.9 Hours
Abstract
BACKGROUND

Abnormal expression patterns of mucin 2 (MUC2) have been reported in a variety of malignant tumors and precancerous lesions. Reduced MUC2 expression in the intestinal mucosa, caused by various pathogenic factors, is related to mechanical dysfunction of the intestinal mucosa barrier and increased intestinal mucosal permeability. However, the relationship between MUC2 and the intestinal mucosal barrier in patients with colorectal cancer (CRC) is not clear.

AIM

To explore the relationship between MUC2 and intestinal mucosal barrier by characterizing the multiple expression patterns of MUC2 in CRC.

METHODS

Immunohistochemical staining was performed on intestinal tissue specimens from 100 CRC patients, including both cancer tissues and adjacent normal tissues. Enzyme-linked immunosorbent assays were performed on preoperative sera from 66 CRC patients and 20 normal sera to detect the serum levels of MUC2, diamine oxide (DAO), and D-lactate (D-LAC). The relationship between MUC2 expression and clinical parameters was calculated by the χ2 test or Fisher’s exact test. Prognostic value of MUC2 was evaluated by Kaplan-Meier curve and log-rank tests.

RESULTS

Immunohistochemical staining of 100 CRC tissues showed that the expression of MUC2 in cancer tissues was lower than that in normal tissues (54% vs 79%, P < 0.05), and it was correlated with tumor-node-metastasis (TNM) stage and lymph node metastasis in CRC patients (P < 0.05). However, the serum level of MUC2 in CRC patients was higher than that in normal controls, and was positively associated with serum levels of human DAO (χ2 = 3.957, P < 0.05) and D-LAC (χ2 = 7.236, P < 0.05), which are the biomarkers of the functional status of the intestinal mucosal barrier. And the serum level of MUC2 was correlated with TNM stage, tumor type, and distant metastasis in CRC patients (P < 0.05). Kaplan-Meier curves showed that decreased MUC2 expression in CRC tissues predicted a poor survival.

CONCLUSION

MUC2 in tissues may play a protective role by participating in the intestinal mucosal barrier and can be used as an indicator to evaluate the prognosis of CRC patients.

Keywords: Colorectal cancer; Mucin 2; Mucin; Expression; Intestinal mucosal barrier; Prognosis

Core Tip: This study found that mucin 2 (MUC2) in intestinal tissues may play a protective role on the intestine and can be used as one of the indicators to evaluate the prognosis of patients with colorectal cancer (CRC). When the intestinal mucosal barrier function of patients with CRC is impaired, the serum level of MUC2 can reflect the severity of the damage. Therefore, in CRC patients with impaired intestinal mucosal barrier function, the serum level of MUC2 could reflect the severity of the damage, providing a potential mechanism for the development of therapeutic strategies for CRC patients.