Immunohistochemical profiling of liver metastases and matched-pair analysis in patients with metastatic pancreatic ductal adenocarcinoma.


Journal

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936

Informations de publication

Date de publication:
Oct 2019
Historique:
received: 19 04 2019
revised: 12 09 2019
accepted: 13 09 2019
pubmed: 23 9 2019
medline: 16 5 2020
entrez: 23 9 2019
Statut: ppublish

Résumé

The purpose of the current study was to investigate the immunohistochemical (IHC) profile of liver metastases (LM) in patients with pancreatic ductal adenocarcinoma (PDAC). Expression of 15 IHC markers in liver biopsies from 77 patients with PDAC, who were diagnosed between 2010 and 2014, were evaluated. In a separate subgroup analysis (n = 12), paired samples (LM and primary tumor) from the same patient were investigated for IHC profile differences. LM samples were classified as pancreatobiliary-type (PB-type) in 72 patients (93.5%), intestinal-type (INT-type) in four patients (5.2%), and squamous in one patient (1.3%). There was no significant difference in overall survival (OS) between LM of the PB-type or INT-type (p = 0.097). In a multivariate analysis, age <70 years (p = 0.047), absence of SMAD4 mutation (p = 0.026), absence of CDX2 expression (p = 0.003), and well to moderate differentiation were significant prognostic factors for better OS in patients with LM (p = 0.031). Analysis of paired tissue samples from LM and the primary tumor revealed a difference in CDX2 (50% increase, p = 0.125) and SMAD4 (33% loss of SMAD4, p = 0.375). CDX2 expression and SMAD4 mutation indicate a poor outcome in patients with LM of PDAC. Matched-pair analysis revealed differences in distinct IHC marker expression.

Sections du résumé

BACKGROUND BACKGROUND
The purpose of the current study was to investigate the immunohistochemical (IHC) profile of liver metastases (LM) in patients with pancreatic ductal adenocarcinoma (PDAC).
METHODS METHODS
Expression of 15 IHC markers in liver biopsies from 77 patients with PDAC, who were diagnosed between 2010 and 2014, were evaluated. In a separate subgroup analysis (n = 12), paired samples (LM and primary tumor) from the same patient were investigated for IHC profile differences.
RESULTS RESULTS
LM samples were classified as pancreatobiliary-type (PB-type) in 72 patients (93.5%), intestinal-type (INT-type) in four patients (5.2%), and squamous in one patient (1.3%). There was no significant difference in overall survival (OS) between LM of the PB-type or INT-type (p = 0.097). In a multivariate analysis, age <70 years (p = 0.047), absence of SMAD4 mutation (p = 0.026), absence of CDX2 expression (p = 0.003), and well to moderate differentiation were significant prognostic factors for better OS in patients with LM (p = 0.031). Analysis of paired tissue samples from LM and the primary tumor revealed a difference in CDX2 (50% increase, p = 0.125) and SMAD4 (33% loss of SMAD4, p = 0.375).
CONCLUSIONS CONCLUSIONS
CDX2 expression and SMAD4 mutation indicate a poor outcome in patients with LM of PDAC. Matched-pair analysis revealed differences in distinct IHC marker expression.

Identifiants

pubmed: 31542399
pii: S1424-3903(19)30726-4
doi: 10.1016/j.pan.2019.09.005
pii:
doi:

Substances chimiques

Biomarkers, Tumor 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

963-970

Informations de copyright

Copyright © 2019 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Auteurs

Thomas Held (T)

Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany; Pancreas Cancer Research Lab, Department of Clinical Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden. Electronic address: thomas.held@med.uni-heidelberg.de.

Caroline S Verbeke (CS)

Department of Pathology, Karolinska University Hospital, Stockholm, Sweden; Institute of Clinical Medicine, University of Oslo, Oslo, Norway. Electronic address: c.s.verbeke@medisin.uio.no.

Oliver Strobel (O)

Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany. Electronic address: oliver.strobel@med.uni-heidelberg.de.

Wiktor Rutkowski (W)

Pancreas Cancer Research Lab, Department of Clinical Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden. Electronic address: wiktor.rutkowski@stud.ki.se.

Christina Villard (C)

Department of Cancer, Karolinska University Hospital, Stockholm, Sweden. Electronic address: christina.villard@sll.se.

Carlos Fernández Moro (CF)

Department of Pathology, Karolinska University Hospital, Stockholm, Sweden. Electronic address: carlos.fernandez.moro@ki.se.

Marco Del Chiaro (M)

Department of Cancer, Karolinska University Hospital, Stockholm, Sweden. Electronic address: marco.del.chiaro@ki.se.

Markus Büchler (M)

Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany. Electronic address: markus.buechler@med.uni-heidelberg.de.

Rainer Heuchel (R)

Pancreas Cancer Research Lab, Department of Clinical Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden. Electronic address: rainer.heuchel@ki.se.

Matthias Löhr (M)

Pancreas Cancer Research Lab, Department of Clinical Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden; Department of Cancer, Karolinska University Hospital, Stockholm, Sweden. Electronic address: matthias.lohr@ki.se.

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