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Postoperative Prognostic Predictors of Pancreatic Ductal Adenocarcinoma: Clinical Analysis and Immunoprofile on Tissue Microarrays

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Most pancreatic ductal adenocarcinomas (PDACs) metastasize even after curative resection. Our goal was to investigate the important factors affecting metastasis and overall survival (OS).

Methods

We studied 88 PDACs with R0 resection and evaluated immunohistochemical markers on tissue microarrays to assess the expression levels of the following: EGFR, amphiregulin, VEGF, p-c-met, MMP2, MMP7, MMP9, CXCR3, and CXCR4.

Results

The median OS in patients who had positive versus negative expression of AREG and MMP9 were 25 versus 16 months and 24 versus 13 months, respectively (P = 0.03, P = 0.006). However, the median OS in patients with positive versus negative expression of MMP2 was 22 versus 37 months (P = 0.04). Immunoprofiles also revealed that patients with positive expression of p-c-met or VEGF had significantly shorter distant metastasis-free survival. Adjuvant treatment, postoperative decrease of CA 19-9, angiolymphatic invasion, AREG, and MMP2 were independent prognostic factors affecting OS in multivariate analysis.

Conclusions

Immunoprofiles revealed the groups with unfavorable tumor biology: negative expression of AREG and positive expression of MMP2. Also, high immunoreactivity of p-c-met or VEGF seemed to be associated with early distant organ metastasis in R0 resected PDACs; however, they still need to be further investigated. These results may give us useful insights in understanding the tumor biology and the patterns of PDAC dissemination.

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Acknowledgment

Supported in part by internal fund #800-20090061SNU in the Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital.

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Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

    Joo Kyung Park MD, Ji Kon Ryu MD, PhD, Yong Bum Yoon MD, PhD & Yong-Tae Kim MD, PhD

  2. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea

    Jin-Hyeok Hwang MD, PhD

  3. Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

    Min A. Kim MD, PhD & Gyeong Hoon Kang MD, PhD

  4. Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea

    Haeryoung Kim MD, PhD

  5. Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

    Sun-Whe Kim MD, PhD

  6. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea

    Ho-Seong Han MD, PhD

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  1. Joo Kyung Park MD
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  2. Min A. Kim MD, PhD
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  3. Ji Kon Ryu MD, PhD
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  6. Ho-Seong Han MD, PhD
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  7. Gyeong Hoon Kang MD, PhD
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  8. Haeryoung Kim MD, PhD
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  9. Jin-Hyeok Hwang MD, PhD
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  10. Yong-Tae Kim MD, PhD
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Corresponding authors

Correspondence to Jin-Hyeok Hwang MD, PhD or Yong-Tae Kim MD, PhD.

Additional information

Joo Kyung Park and Min A. Kim contributed equally to this work.

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Park, J.K., Kim, M.A., Ryu, J.K. et al. Postoperative Prognostic Predictors of Pancreatic Ductal Adenocarcinoma: Clinical Analysis and Immunoprofile on Tissue Microarrays. Ann Surg Oncol 19, 2664–2672 (2012). https://doi.org/10.1245/s10434-012-2277-7

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  • DOI: https://doi.org/10.1245/s10434-012-2277-7

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