Prognostic evaluation of mucin-5AC expression in intrahepatic cholangiocarcinoma, mass-forming type, following hepatectomy

Eur J Surg Oncol. 2015 Nov;41(11):1515-21. doi: 10.1016/j.ejso.2015.07.006. Epub 2015 Jul 17.


Aim: This study aimed to investigate the clinicopathological predictors of survival in patients with intrahepatic cholangiocarcinoma, mass-forming type (ICC-MF), following curative intent hepatectomy.

Methods: Clinical characteristics and outcomes were analyzed in a series of 42 patients who underwent curative hepatectomy for ICC-MF between February 1987 and December 2012. The relationship between immunohistochemical expression profiles of mucin (MUC) core proteins (MUC2, MUC5AC, and MUC6) and surgical outcomes was examined.

Results: The overall median follow-up period was 2.6 years (0.2-17.9). Bile duct reconstruction (p = 0.017), lymph node metastasis (p = 0.049), maximal mass diameter ≥5.0 cm (p = 0.002), and MUC5AC expression (p = 0.003) were identified as significant adverse predictors of overall survival by univariate analysis. Bile duct reconstruction (p = 0.048), maximal mass diameter ≥5.0 cm (p = 0.002), and MUC5AC expression (p = 0.005) were found to be independent predictors of poor prognosis by multivariate analysis. Maximal mass diameter ≥5.0 cm (p = 0.011) was found to be an independent predictor for the tumor recurrence. There was a strong correlation between MUC5AC expression and lymph node metastasis (p = 0.021). MUC6 expression was more frequent in patients with concurrent MUC5AC expression (p = 0.019).

Conclusions: MUC5AC expression was significantly related to long-term prognosis and aggressive tumor development, and may be a useful prognostic marker.

Keywords: Intrahepatic cholangiocarcinoma; Mass-forming type; Mucin core protein.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bile Duct Neoplasms / diagnosis
  • Bile Duct Neoplasms / metabolism*
  • Bile Duct Neoplasms / surgery
  • Bile Ducts, Intrahepatic*
  • Biomarkers, Tumor / biosynthesis
  • Cholangiocarcinoma / diagnosis
  • Cholangiocarcinoma / metabolism*
  • Cholangiocarcinoma / surgery
  • Female
  • Follow-Up Studies
  • Hepatectomy*
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Mucin 5AC / biosynthesis*
  • Neoplasm Staging
  • Postoperative Period
  • Prognosis
  • Retrospective Studies
  • Time Factors
  • Tomography, X-Ray Computed


  • Biomarkers, Tumor
  • Mucin 5AC