Abstract
Objectives To investigate the relationship between the expression of hENT1 protein in pancreatic cancer and the efficacy, adverse reactions and prognosis of gemcitabine. Methods The tissues of 83 patients with pancreatic cancer diagnosed in Department of Hepatobiliary and Pancreatic Surgery of Jiaxing Second Hospital and Jiaxing City Hospital of Traditional Chinese Medicine from June 2013 to January 2016 were collected by endoscopic fine needle aspiration biopsy. The expression of hENT1 protein was detected by immunohistochemistry, which was divided into hENT1 low expression group and high expression group. According to the curative effect of chemotherapy, it was divided into gemcitabine effective group and drug resistance group. The clinicopathological parameters, adverse reaction rate, median survival, and progression-free survival (PFS) were compared between the two groups. Results Of the 83 pancreatic cancer tissues, 37(44.6%) had high expression of hENT1 and 46(55.4%) had low expression. There were no significant correlations of the efficacy of gemcitabine chemotherapy with gender, age, clinical symptoms, primary tumor location, tumor size, TNM staging, CA19-9 level, CEA level, presence or absence of liver metastasis, but gemcitabine resistance rate in high expression group was significantly higher than the low expression group (78.1% vs 50.0%), and the difference was statistically significant (P=0.010). Both groups were able to tolerate adverse reactions of gemcitabine chemotherapy and no chemotherapy-related death was observed, but the incidence of leucopenia and thrombocytopenia in hENT1 low expression group was significantly higher than those in hENT1 protein high expression group (63.0% vs 21.6%, 47.8% vs 16.2%), the differences was statistically significant (all P<0.05). The median survival and 1-year PFS of hENT1 protein low expression group were significantly lower than those of high expression group (11 months vs 15 months, 19.4% vs 50%), and the differences were statistically significant (P<0.05). Conclusions Decreased hENT1 protein expression in pancreatic cancer tissue could reduce the efficacy of gemcitabine chemotherapy, increasing the incidence of leucopenia and thrombocytopenia. Key words: Pancreatic neoplasms; Balanced nucleotide transporter1; Gemcitabine; Prognosis
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