Prognostic Impact of Cell Division Cycle Associated 2 Expression on Pancreatic Ductal Adenocarcinoma

Objective To examine the expression of cell division cycle associated 2(CDCA 2) in pancreatic ductal adenocarcinoma(PDAC) and investigate its role in prognosis of PDAC patients.Methods This retrospective study included 155 PDAC patients who underwent surgical treatment and complete post-operative follow-up.Clinicopathologic data were collected through clinical database.Tissue microarray was constructed and immunohistochemistry was performed to detect CDCA2 expression in the PDAC tumor tissues and adjacent non-tumor tissues.Clinicopathological characteristics between high and low CDCA2 expression were compared.Correlation of CDCA2 expressions with patients' survival was analyzed using Kaplan-Meier method and Cox regression analysis.Results Expression of CDCA2 in PDAC cells was significantly higher than that in adjacent non-tumor tissues(U=4056.5,P<0.001).Univariate analysis showed that CDCA2 expression [hazard ratio(HR)=1.574,95% confidence interval(CI)=1.014-2.443,P=0.043] and node metastasis(HR=1.704,95%CI=1.183-2.454,P=0.004) were significantly associated with prognosis.Cox regression analysis showed CDCA2 expression was not an independent prognostic risk factor(HR=1.418,95%CI=0.897-2.242,P=0.135) for PDCA patients.Stratification survival analysis demonstrated CDCA2 expression as an independent prognostic risk factor in male patients(HR=2.554,95%CI=1.446-4.511,P=0.003) or in non-perineural invasion patients(HR=2.290,95%CI=1.146-4.577,P=0.012).Conclusions CDCA2 is highly expressed in PDAC tumor tissue.Although CDCA2 is not an independent prognostic risk factor for PDAC patients,it might be used to help predict prognosis of male or non-perineural invasion patients of PDAC.

Prognostic significance of SUVmax and serum carbohydrate antigen 19-9 in pancreatic cancer

AIM:To investigate the prognostic significance of pretreatment standardized maximum uptake value(SUVmax)and serum carbohydrate antigen(CA)19-9 in pancreatic cancer.METHODS:From January 2007 to October 2011,80 consecutive patients with pancreatic cancer who received positron emission/computed tomography before any treatment were enrolled in this study.The pretreatment SUVmax and CA19-9 level of the primary pancreatic tumor were obtained and compared with clinicopathological and prognostic factors.Student’s t test for unpaired data was used to analyze the differences between two groups.Univariate analysis and Cox proportional hazards regression were used to examine the independent effects of each significant variable.Survival was analyzed by the Kaplan-Meier method.RESULTS:There was a significant correlation between both the SUVmax and serum CA19-9 of pancreatic cancer and R0 surgical resection(P=0.043 and P=0.007).Lymph node metastasis was associated with SUVmax(P=0.017),but not serum CA19-9(P=0.172).On the contrary,the tumor stage was significantly related to serum CA19-9(P=0.035),but not SUVmax(P=0.110).The univariate analysis showed that survival time was significantly related to tumor stage(P<0.001),lymph node metastasis(P=0.043),R0 surgical resection(P<0.001),serum CA19-9(P=0.001),SUVmax(P<0.001)and SUVmax plus CA19-9(P=0.002).Multivariate analysis clearly showed that only tumor stage(hazard ratio=0.452;P=0.020)was an independent prognostic factor for overall survival in pancreatic cancer.Higher SUVmax or CA19-9showed worse prognosis.We found that high serum CA19-9 plus SUVmax was the most significant variable.CONCLUSION:Higher pretreatment SUVmax and serum CA19-9 indicates poor prognosis.SUVmax plus serum CA19-9 is the most significant variable in predicting survival.