Efficacy of differential mucin staining for predicting synchronous and metachronous colorectal carcinomas

Despite the controversy regarding the significance and usefulness of histochemically differential mucin staining as a marker for colorectal neoplasms, some investigators have used this technique to help define those persons at risk for development of recurrent colorectal carcinoma. To further evaluate the efficacy of this method, we reviewed 85 surgical specimens of the colon and rectum using a high iron diamine-alcian blue staining technique. The group studied included 73 patients with synchronous or metachronous carcinomas and adenomas and 12 patients with no recurrence for more than 5 years who had undergone adequate follow-up, including physical examination; evaluation of serum chemistry findings; and colonoscopy, barium enema, or both. Evaluation of Dukes' staging (A and B1 versus B2 and C2) and distance of the resection margins from the tumor (less than 5 cm versus 5 cm or more) showed no correlation with the amount of sialomucin present. Resection margins from patients with either synchronous or metachronous carcinomas had significantly higher sialomucin ratios than the group without recurrence, whereas those with synchronous or metachronous adenomas did not. The false-negative rate was 4 percent (1 of 23 specimens) and the false-positive rate, 42 percent (5 of 12 specimens). We conclude that this method for evaluating resection margins of colorectal cancer specimens with differential mucin staining is highly reliable for predicting the population with synchronous and metachronous colorectal carcinomas.