Abstract
PurposeTo investigate the role of podoplanin (PDPN) expression in invasive ductal carcinoma of the pancreas (IDCP) in humans.MethodsTumor samples were obtained from 95 patients with IDCP. Immunohistochemical staining was done to evaluate the expression of PDPN in cancer tissues.ResultsPDPN was detected predominantly in stromal fibroblasts, stained with α-smooth muscle actin. The cutoff value of PDPN-positive areas was calculated according to a histogram. There was no significant difference in clinicopathologic factors between patients with high vs. those with low PDPN expression. The high PDPN group showed significantly poorer disease-free and disease-specific survival rates than the low PDPN group. Among patients from the high PDPN group, those with lymph node metastases and those with a tumor larger than 20 cm in diameter had significantly poorer prognoses than similar patients from the low PDPN group. Multivariate Cox proportional hazards analysis indicated that a high expression of PDPN was an independent risk factor for disease-specific survival.ConclusionsPDPN expression in cancer-related fibrotic tissues is associated with a poor prognosis, especially in patients with large tumors or lymph node metastases.
Highlights
Pancreatic cancer is associated with one of the poorest prognoses of any cancer because early detection is difficult and it progresses rapidly [1,2,3]
PDPN expression in cancer-related fibrotic tissues is associated with a poor prognosis, especially in patients with large tumors or lymph node metastases
Since pancreatic cancer is rich in fibrous tissues, we investigated the correlation between PDPN expression in stromal fibroblasts in invasive ductal carcinoma of the pancreas (IDCP) and prognosis in humans
Summary
Pancreatic cancer is associated with one of the poorest prognoses of any cancer because early detection is difficult and it progresses rapidly [1,2,3]. The number of deaths from pancreatic cancer is increasing in Japan. More than 30,000 deaths from pancreatic cancer in 2013 slightly exceeded the number of deaths from liver cancer in the same year [4]. Pancreatic fibrosis is one of the histopathologic findings at the time of the desmoplastic reaction associated with chronic pancreatitis or pancreatic cancer. Pancreatic stellate cells (PSCs) were first isolated and identified in the pancreas in 1998 [5, 6]. It was found that PSCs are similar to liver stellate cells and play a pivotal role in pancreatic fibrosis. PSCs are quiescent and store cytoplasmic vitamin A-containing lipid droplets [7]
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