Journal of Gastrointestinal Cancer

, Volume 50, Issue 1, pp 54–61 | Cite as

Expression and Serum Levels of Mucin 5AC (MUC5AC) as a Biomarker for Cholangiocarcinoma: a Meta-analysis

  • Noel PabalanEmail author
  • Sutawadee Sukcharoensin
  • Kritiya Butthongkomvong
  • Hamdi Jarjanazi
  • Veerachai Thitapakorn
Original Research



The potential of biomarkers in detecting early cholangiocarcinoma (CCA) is facilitated by examining CCA-associated proteins from primary studies. One such protein is mucin 5AC (MUC5AC) but inconsistency of reported associations between its expression/serum levels and CCA prompts a meta-analysis to obtain more precise estimates.


A literature search yielded 17 included articles where multiple data in some raised the number of studies to 22. We calculated pooled odds ratios (OR) and 95% confidence intervals from negative and positive readings of MUC5AC levels. Data were subgrouped by ethnicity, detection method, sample source, and cancer type.


Outcome in the overall analysis was non-significant but those in the subgroups were. Thus, significant associations (P < 0.001) indicating high MUC5AC levels were found in three subgroups: (i) Thai (OR 8.32) and (ii) serum (OR 4.52). Heterogeneity of these two outcomes (I2 = 90–93%) was erased with outlier treatment (I2 = 0%) which also modulated the pooled effects (OR 2.48–2.59). (iii) Immunoblot (OR 2.61) had low initial heterogeneity (I2 = 2%). Robustness and significant tests for interaction (Pinteraction = 0.01–0.02) improved MUC5AC associations with CCA in the Thai population.


Our pooled effect findings target the biomarker potential of MUC5AC to the Thai population.


MUC5AC Biomarker Meta-analysis Cholangiocarcinoma 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that there are no conflicts of interest.

Supplementary material

12029_2017_32_MOESM1_ESM.docx (26 kb)
Supplementary Table S1 (DOCX 26 kb).


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Chulabhorn International College of MedicineThammasat UniversityKhlong LuangThailand
  2. 2.Medical Oncology UnitUdonthani Cancer HospitalUdonthaniThailand
  3. 3.Environmental Monitoring and Reporting BranchOntario Ministry of the Environment and Climate ChangeTorontoCanada

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