Evaluation of serum MUC5AC for identifying high grade cervical lesions in a prospective cohort from Türkiye

Abnormal expression of mucins and changes in their glycosylation are linked to the onset and advancement of cancerous conditions. This research sought to assess the diagnostic significance of serum MUC5AC levels in differentiating between high-grade cervical intraepithelial lesions, low-grade lesions, and normal cervical findings, as well as to investigate its potential as a non-invasive biomarker to enhance cervical cancer screening and early detection methods.

A total of 138 women were stratified into three groups: CIN 1 (LSIL) (n = 38), CIN 2-3 (HSIL) (n = 54), and controls (n = 46). Serum levels of MUC5AC were assessed through enzyme-linked immunosorbent assay (ELISA). All participants underwent cytological assessment, HPV testing, and colposcopy with targeted biopsy; endocervical curettage and LEEP were performed when indicated.

Serum MUC5AC levels were significantly higher in the CIN 2-3 group compared to both the control and CIN 1 groups (p = 0.016), while no significant difference was found between the control and CIN 1 groups. ROC analysis demonstrated that MUC5AC had moderate diagnostic performance in distinguishing CIN 2-3 from controls (AUC = 0.634, p = 0.022) and from CIN 1 (AUC = 0.658, p = 0.011), with high sensitivity but low specificity. No significant discriminative value was observed in the comparisons involving the CIN 1 and control groups.

Serum MUC5AC exhibited significant sensitivity in detecting high-grade cervical lesions; however, its specificity was somewhat restricted. Although it may not serve as an adequate standalone marker for early lesions, it shows potential for identifying advanced pathology.