Impact of p53 and PDGFR-β Expression on Metastasis and Prognosis of Patients with Pancreatic Cancer.

Abstract

Identifying novel predictors of hematogenous metastasis is essential to select optimal therapeutic strategies for pancreatic cancer. The goal of this study was to clarify the clinical implications of p53 and platelet-derived growth factor receptor-β (PDGFR-β) in pancreatic cancer using immunohistochemistry (IHC). Specimens obtained by surgical resection and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of the primary tumor were used for IHC. EUS-FNA was performed before any treatment. We analyzed the clinical implications of p53 and PDGFR-β IHC. We also performed a comparative analysis of the IHC findings between surgical and EUS-FNA specimens. This study involved 149 patients (120 who did not receive and 29 who received preoperative therapy). EUS-FNA specimens were obtained from 20 patients without preoperative therapy and 20 patients with preoperative therapy. Abnormal p53 and high PDGFR-β expression was significantly correlated with a high incidence of hematogenous metastasis (p<0.001) and poor postoperative survival (p=0.006). In patients without preoperative therapy, the results for p53 and PDGFR-β staining were concordant between surgical and EUS-FNA specimens in 95% of the cases. In patients with preoperative therapy, 80 and 70% of the patients showed consistent p53 and PDGFR-β expression between surgical and EUS-FNA specimens, respectively. Pancreatic cancer patients with simultaneous abnormal p53 and high PDGFR-β expression have a significantly higher risk of hematogenous metastasis and a poor prognosis after surgery. IHC evaluation using EUS-FNA specimens may be able to identify patients with highly metastatic pancreatic cancer who may benefit from aggressive therapeutic intervention.