MUC5AC Protein Expression as a Potential Predictor of Metastasis in Mucinous Ovarian Carcinoma: Unveiling a New Biomarker in a Rare Cancer Subtype

Abstract

BACKGROUND: Mucinous ovarian carcinoma (MOC) is a distinct and lethal histological subtype of ovarian cancer, frequently characterized by late-stage diagnosis and chemoresistance. The role of MUC5AC a gel-forming mucin associated with aggressive behavior in various epithelial malignancies remains under-investigated in the context of MOC metastasis, particularly within Indonesian populations. This study aimed to evaluate the correlation between MUC5AC expression and metastatic occurrence in MOC to determine its utility as a predictive biomarker. METHODS: A retrospective analysis was conducted on 63 MOC tissue samples, collected between 2021 and 2024. MUC5AC expression was evaluated via immunohistochemistry (IHC) using a semi-quantitative scoring system. Statistical associations were determined using the Chi-square test, with an emphasis on calculating the odds ratio (OR) for metastatic risk. RESULTS: Among the 63 cases, metastatic involvement (omental or extra-ovarian) was identified in 37 samples (58.7%). A significant correlation was noted between high MUC5AC expression and the occurrence of metastasis in MOC (p=0.002). Furthermore, tumors exhibiting high MUC5AC expression demonstrated a 6.4-fold increased probability of metastasis compared to those with low expression (OR = 6.40; 95% CI: 1.89-21.5). CONCLUSION: Elevated MUC5AC expression is significantly correlated with metastatic involvement in primary MOC. These findings suggest that MUC5AC has the potential to serve as a predictive biomarker for metastasis in this rare cancer subtype, potentially assisting in the identification of patients who require more intensive staging and surveillance.

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