Pseudomyxoma Peritonei: Is Disease Progression Related to Microbial Agents? A Study of Bacteria, MUC2 and MUC5AC Expression in Disseminated Peritoneal Adenomucinosis and Peritoneal Mucinous Carcinomatosis

Background and Aims Pseudomyxoma peritonei (PMP) is characterized by peritoneal tumors arising from a perforated appendiceal adenoma or adenocarcinoma, but associated entry of enteric bacteria in the peritoneum has not been considered as a cofactor. Because Gram-negative organisms can upregulate MUC...

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Bibliographic Details
Published in:Annals of surgical oncology 2008-05, Vol.15 (5), p.1414-1423
Main Authors: Semino-Mora, Cristina, Liu, Hui, McAvoy, Thomas, Nieroda, Carol, Studeman, Kimberley, Sardi, Armando, Dubois, Andre
Format: Article
Language:English
Subjects:
Adenocarcinoma, Mucinous - metabolism
Adenocarcinoma, Mucinous - microbiology
Appendix - metabolism
Biomarkers, Tumor - genetics
Biomarkers, Tumor - metabolism
Case-Control Studies
Disease Progression
DNA Probes
Gastrointestinal Oncology
Gene Expression Regulation, Neoplastic
Helicobacter Infections - metabolism
Helicobacter Infections - microbiology
Helicobacter pylori
Helicobacter pylori - pathogenicity
Humans
In Situ Hybridization
Medicine
Medicine & Public Health
Microscopy, Electron, Transmission
Mucin 5AC
Mucin-2
Mucins - genetics
Mucins - metabolism
Oncology
Peritoneal Neoplasms - metabolism
Peritoneal Neoplasms - microbiology
Prognosis
Pseudomyxoma Peritonei - metabolism
Pseudomyxoma Peritonei - microbiology
RNA Probes
Surgery
Surgical Oncology
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Summary:Background and Aims Pseudomyxoma peritonei (PMP) is characterized by peritoneal tumors arising from a perforated appendiceal adenoma or adenocarcinoma, but associated entry of enteric bacteria in the peritoneum has not been considered as a cofactor. Because Gram-negative organisms can upregulate MUC2 mucin gene expression, we determined whether bacteria were detectable in PMP tissues. Methods In situ hybridization was performed on resection specimens from five control subjects with noninflamed, nonperforated, non-neoplastic appendix and 16 patients with PMP [six with disseminated peritoneal adenomucinosis (DPAM) and 10 with peritoneal mucinous carcinomatosis (PMCA)]. Specific probes were designed to recognize: (1) 16S rRNA common to multiple bacteria or specific to H. pylori ; (2) H. pylori cagA virulence gene; or (3) MUC2 or MUC5AC apomucins. Specimens from one patient with PMCA were examined by ultrastructural immunohistochemistry. Bacterial density and apomucin expression were determined in four histopathological compartments (epithelia, inflammatory cells, stroma, and free mucus). Results Enteric bacteria were detected in all specimens. Bacterial density and MUC2 expression were significantly ( p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-007-9778-9