Abstract
BackgroundPancreatic neuroendocrine tumors (pNETs) are a heterogeneous group of neoplasms with malignant behaviors that can develop from inert slow growth or low malignancy to aggressive metastasis during follow-up. Recently, vimentin and E-cadherin were shown to be prognostic markers in some malignant tumors but were not evaluated in pNETs. The aim of this study was to evaluate the expression and prognostic significance of vimentin and E-cadherin in grade 1 and 2 pNETs.MethodsA retrospective review of 227 patients with grade 1 and 2 pNETs undergoing surgical resection was conducted. Tumor specimens were immunohistochemically stained for vimentin and E-cadherin. Correlations between vimentin and E-cadherin expression and other clinicopathological features were then analyzed. Furthermore, overall survival (OS) and disease-free survival (DFS) were evaluated using Kaplan-Meier and univariate and multivariate Cox regression methods.ResultsAmong 227 patients, 55 (24.2%) harbored tumors with high vimentin expression, while 117 (51.5%) harbored tumors with loss of E-cadherin expression. Patients with high vimentin expression and loss of E-cadherin expression had significantly elevated risks of lymph node metastasis, distant metastasis, perineural invasion and an advanced American Joint Committee on Cancer (AJCC) stage compared with those with low vimentin expression and preserved E-cadherin expression, high vimentin expression and preserved E-cadherin expression, or low vimentin expression and loss of E-cadherin expression. Furthermore, multivariate analysis showed that high vimentin expression with loss of E-cadherin expression was an independent predictor of OS and DFS in patients with grade 1 and 2 pNETs who underwent resection (both P < 0.001).ConclusionsThe current study demonstrated that high vimentin expression with loss of E-cadherin expression was correlated with lymph node metastasis, distant metastasis, disease progression and a poor prognosis in patients with grade 1 and 2 pNETs who underwent resection.
Highlights
Pancreatic neuroendocrine tumors are a heterogeneous group of neoplasms with malignant behaviors that can develop from inert slow growth or low malignancy to aggressive metastasis during follow-up
Several large cohort studies found that lymph node involvement, tumor stage and grade, tumor size and Ki-67 index scores could predict the prognosis of Pancreatic neuroendocrine tumor (pNET) [5,6,7]
With the aim of gaining insight into the molecular and clinical mechanisms underlying metastatic progression, the present study evaluated the expression of vimentin and E-cadherin and their effects on the progression and prognosis of patients with grade 1 and 2 pNETs who underwent surgery
Summary
Pancreatic neuroendocrine tumors (pNETs) are a heterogeneous group of neoplasms with malignant behaviors that can develop from inert slow growth or low malignancy to aggressive metastasis during follow-up. Vimentin and E-cadherin were shown to be prognostic markers in some malignant tumors but were not evaluated in pNETs. The aim of this study was to evaluate the expression and prognostic significance of vimentin and E-cadherin in grade 1 and 2 pNETs. Pancreatic neuroendocrine tumors (pNETs) are a rare heterogeneous group of neoplasms that represent approximately 2% of all pancreatic neoplasms [1, 2]. Several large cohort studies found that lymph node involvement, tumor stage and grade, tumor size and Ki-67 index scores could predict the prognosis of pNETs [5,6,7]. Little is known about the molecular and cellular mechanisms involved in the invasion and metastasis of pNETs
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