Low Expression of Mucin 2, High Expression of Mucin 13, and High Expression of Nuclear Factor Kappa-Light-Enhancer of Activated B Cells were Significant Pathways in Colorectal Cancer Development

Objective: To prove the role of MUC2, MUC13, and NFκB protein expression as significant carcinogenesis pathways in colorectal cancer development. Methods: This is a nested case-control study conducted at the Udayana University, Sanglah General hospital, from September 2020 to 2021. All eligible subjects who visited the Digestive Surgery outpatient clinic with a colorectal surgery plan 2021 were included. The subjects were classified as case group (cancerous colonic mucosa) and control group (normal colonic mucosa), proved by histopathology examination. The parameters in this study were the expression of MUC2, MUC13, and NFκB by immunohistochemistry analysis. The data in this study will be collected and tabulated in SPSS 25.0 (Chicago, Illinois, USA). Results: A total of 36 subjects with colorectal cancer (case group) and 36 subjects with normal colonic mucosa (control group) were analyzed in this study. The cancerous colonic mucosa significantly had a lower MUC2, higher MUC13, and higher NFκB expression. After multivariate analysis for controlling the age variable, the result showed that only MUC2, MUC13, and NFκB expressions were still significant with p<0.05. The effect from MUC2, MUC13, and NFκB expression totally could assess up to 85.4% of the risk of developing colorectal cancer. Conclusion: There was a significantly lower MUC2, higher MUC13, and higher NFκB expression in the carcinogenesis of colorectal cancer, representing the influence of the inflammatory pathway and the abnormality of the protective barrier. Therefore, in the future, this result could remark a future early prediction or scoring system to assess colorectal cancer in clinical application.