Tenascin C is upregulated around perineural invasion of pancreatic ductal adenocarcinoma and correlates with locoregional recurrence

Abstract

Introduction: Pancreatic ductal adenocarcinoma (PDAC) is characterized by stromal desmoplasia and perineural invasion. However, mechanisms which drive stromal change and neural tropism in cancer progression remain unclear. Tenascin C (TNC), an extracellular matrix glycoprotein, has been reported to be expressed mainly in cancer stroma and associated with metastasis and poor prognosis in PDAC. The aim of this study is to evaluate relationships between TNC expressions around nerves and clinicopathological features in resected PDAC. Method: A total of 79 PDAC patients without receiving any preoperative treatment who underwent surgical resection between January 2000 and May 2017 were enrolled in this study. TNC expression was examined immunohistochemically on paraffin-embedded sections from resected specimen. The perineural staining intensity of TNC in invasive front of pancreatic cancer was defined as high or low (Image), by comparing with that in adjacent non-cancerous tissue in the same section. The relationships between TNC expression and clinicopathological features were retrospectively analyzed. Results: High TNC perineural expression in invasive front was seen in 30 (38%) patients, and associated with perineural invasion (p=0.006), pT3 ≤ (p=0.01), lymph node metastasis (p=0.038) and postoperative locoregional recurrence (p=0.039). High perineural TNC expression was significantly associated with worse recurrence free survival rates by univariate analysis. Conclusions: Perineural TNC expression is a potential predictable marker for locoregional recurrence.