Abstract
To investigate retrospectively whether alterations of p53 upregulated mediator of apoptosis (PUMA) protein levels and somatic mutations of the PUMA gene are characteristic of pancreatic ductal adenocarcinoma (PDAC). Immunohistochemical analyses of PUMA were performed in pancreatic tumour tissue samples, and paired normal pancreatic tissue samples, from patients with PDAC. Apoptosis was detected using terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labelling assay. A total of 70 patients with PDAC had samples available; 49 cases (70.0%) had high PUMA protein levels. PUMA was not detected in paired normal tissue samples. Significantly higher levels of PUMA protein were detected in low-grade tumours (tumour -node-metastasis stages I and II), compared with higher grade (stage III) tumours. Of the PDAC cases, the mean apoptosis index value for PUMA-positive specimens was significantly higher than that for PUMA-negative specimens. Overall survival was significantly associated with PUMA immunoreactivity. High levels of PUMA in PDAC tumour cells suggest that PUMA expression may play a role in pancreatic tumourigenesis.
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