e21053 Background: Heat shock protein 27 (HSP27) is a stress-inducible protein preventing the accumulation of misfolded proteins and participating in the regulation of apoptosis. The role of HSP27 as a biomarker has been investigated in a variety of tumor entities, but little is known about its significance in pancreatic cancer. Applying tissue microarray (TMA) analysis, we correlated HSP27 protein expression with clinical-pathological parameters in surgical specimen from 86 pancreatic cancer patients. Methods: Immunohistochemistry, TMA, database analysis. Results: We found HSP27 expression in 49% of pancreatic cancer samples. HSP27 was predominantly expressed in the cytoplasm. Additionally, membranous staining was observed in single cases. There was no association between HSP27 expression and gender, age, grading, lymph node status, metastases, resection status or tumor size. However, HSP27 expression was strongly correlated with better post-operative survival. Consistently, Kaplan-Meier analyses confirmed a significant influence of HSP27 expression on survival. Other parameters affecting survival were expectedly lymph node status, metastases, and tumor size. The univariate analyses regarding HSP27 expression were reproducible using multivariate Cox-regression analyses adjusted for age, gender, grading, resection status, lymph node status, metastases, and tumor size. Finally, backward selection, excluding the least significant factor one at a time, further supported HSP27 expression to be an independent survival factor in pancreatic cancer. Conclusions: Applying TMA analyses of 86 patients with pancreatic cancer, we identified HSP27 as an independent prognostic biomarker in this tumor type. Additional clinical implications could arise from future studies clarifying the underlying mechanism for this observation, especially in regard to a potential association between HSP27 expression and response to chemotherapy. No significant financial relationships to disclose.
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