MUC5AC: nuovo marker sierico nel colangiocarcinoma intraepatico e peri-ilare

Background and aims: cholangiocarcinoma is the second more frequent primary neoplasm of the liver. Surgical resection is still the only therapy that can achieve good long-term results. Diagnosis and prognostic stratification are the two most debated issues in the surgical treatment of this disease. MUC 5AC is a mucinous protein that is expressed by different human tissues and had been identified in different epithelial cancers. The aim of this study was to investigate the role of serum assessment of MUC 5AC in a group of patients with intrahepatic and peri-hilar cholangiocarcinoma. The diagnostic role compared to CA 19.9 and CEA and the prognostic role in patients submitted to surgical resection were investigated. Patients and methods: 69 patients with cholangiocarcinoma, biliary lithiasis and hepatolithiasis, other primary and secondary liver cancers and a group of control subjects were included into this study. Serum assessment of MUC 5AC was performed with ELISA method. Results: Serum MUC 5AC was significantly higher in patients with cholangiocarcinoma compared to biliary lithiasis, hepatolithiasis, other primary or secondary liver tumors and control subjects. The diagnostic value of serum MUC 5AC was investigated with ROC curve analysis. The AUC of serum MUC 5AC for the diagnosis of cancer was significantly higher compared to CA 19.9 and CEA. In cholangiocarcinoma’ patients the serum values of MUC5AC was significantly higher in patients with metastatic disease (stage TNM IVb). The survival after surgical resection was higher in patients with serum MUC 5AC < 13 ng/ml. Conclusions Serum MUC 5AC proved to be useful as diagnostic tool for identification of cholangiocarcinoma. The diagnostic value of MUC 5AC proved to be higher compared to CA 19.9 and CEA. Moreover serum MUC 5AC proved to have prognostic value with relationship with tumor stage and survival.