1. Prognostic significance of stem cell/ epithelial-mesenchymal transition markers in periampullary/pancreatic cancers: FGFR1 is a promising prognostic marker
- Author
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Nishant Thakur, Yosep Chong, Kwang Yeol Paik, Chang Suk Kang, and Eun-Jung Lee
- Subjects
Male ,0301 basic medicine ,Cancer Research ,Pathology ,Duodenal neoplasms ,Perineural invasion ,Kaplan-Meier Estimate ,Stem cell marker ,SOX transcription factor ,0302 clinical medicine ,Fibrosis ,Common bile duct neoplasm ,Medicine ,Octamer transcription factor-4 ,Aged, 80 and over ,Tissue microarray ,Pancreatic ductal carcinoma ,Ampulla of Vater ,Middle Aged ,Prognosis ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Fibroblast growth factor receptor ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Neoplastic Stem Cells ,Female ,Stem cell ,Research Article ,Adult ,medicine.medical_specialty ,Epithelial-Mesenchymal Transition ,Common Bile Duct Neoplasms ,lcsh:RC254-282 ,Disease-Free Survival ,03 medical and health sciences ,Cancer stem cell ,Biomarkers, Tumor ,Genetics ,Humans ,Receptor, Fibroblast Growth Factor, Type 1 ,Epithelial–mesenchymal transition ,Aged ,Neoplasm Staging ,business.industry ,medicine.disease ,Pancreatic Neoplasms ,030104 developmental biology ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Background Periampullary cancers (PAC) including pancreatic, ampulla of Vater (AOV), and common bile duct (CBD) cancers are highly aggressive with a lack of useful prognostic markers beyond T stage. However, T staging can be biased due to the anatomic complexity of this region. Recently, several markers related to cancer stem cells and epithelial-mesenchymal transition (EMT) such as octamer transcription factor-4 (Oct4) and fibroblast growth factor receptor 1 (FGFR1) respectively, have been proposed as new promising markers in other solid cancers. The aim of this study was to assess the expression and prognostic significance of stem cell/EMT markers in PACs. Methods Formalin-fixed, paraffin-embedded tissues of surgically excised PACs from the laboratory archives from 1998 to 2014 were evaluated by immunohistochemical staining for stem cell/EMT markers using tissue microarray. The clinicopathologic parameters were documented and statistically analyzed with the immunohistochemical findings. Survival and recurrence data were collected and analyzed. Results A total of 126 PAC cases were evaluated. The average age was 63 years, with 76 male and 50 female patient samples. Age less than 74 years, AOV cancers, lower T & N stage, lower tumor size, no lymphatic, vascular, perineural invasion and histologic well differentiation, intestinal type, no fibrosis, severe inflammation were significantly associated with the better overall survival High expression levels of FGFR1 as well as CK20, CDX2, and VEGF were significantly related to better overall survival, while other stem cell markers were not related. Similar findings were observed for tumor recurrence using disease-free survival. Conclusions In addition to other clinicopathologic parameters, severe fibrosis was related to frequent tumor recurrence, and high FGFR1 expression was associated with better overall survival. Histologic changes such as extensive fibrosis need to be investigated further in relation to EMT of PACs.
- Published
- 2020