Published online Jul 7, 2021. doi: 10.3748/wjg.v27.i25.3888
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
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.
To explore the relationship between MUC2 and intestinal mucosal barrier by characterizing the multiple expression patterns of MUC2 in CRC.
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.
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.
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.
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.