Most of the world authorities have agreed on the definition criteria of high-risk features that include (1) the MRF invasion (MRF+), (2) presence of extramural vascular invasion (EMVI+), (3) tumor deposits (TDs), (4) lymph node infiltration, (5) intrinsic tumor factors such as proximity or infiltration of the anal canal and the sphincteric apparatus, and (6) presence of mucin [37]. Here, MUC5AC is linked to neoplasm.