TISSUE FACTOR PATHWAY INHIBITOR-2 AS A PROGNOSTIC FACTOR IN PANCREATIC CARCINOMA

Objective To establish the correlation between tissue factor pathway inhibitor 2 (TFPI-2) and the progression of pancreatic carcinoma(PC) after detecting the expression level of TFPI-2 in PC,and to evaluate the value of TFPI-2 as prognostic index in PC.Methods Expression levels of TFPI-2 in 10 normal and 25 cancerous/juxta-cancerous pancreas were testified with Western blot and RTPCR analyses respectively.Expression density of TFPI-2 in each group was analyzed with HPIAS image analyzer and compared with ANOVA.The correlation between the expression level of TFPI-2 and malignancy was tested with Spearman rank correlation.Disease-specific survival curves were calculated according to Kaplan Meier algorithm,and log rank test was used to compare survival curves.Then,Cox regression analysis was applied to determine the single contribution of each covariate on survival rate.Results The expression level of TFPI-2 decreased along with progression of PC with significant difference among groups (P <0.05),and there was a significantly negative correlation between TFPI-2 protein and progression (r= -ft 816,P <0.001).Among the 13 studied variables,such as the expression level of TFPI-2 protein, tumor stage,portal vein resection,lymph node metastasis,only lymph node metastasis was a predictor of outcome.However,when we analyzed the survival without considering lymph node metastasis,a stepwise Cox analysis showed that expression level of TFPI-2 protein and combined organ resection were significantly associated to survival.Conclusion The data showed that there was strongly correlation between the expression level of TFPI-2 and the progression and survival of PC,which suggested that TFPI-2 could be a newly prognostic factor and a novel approach for gene therapy for PC.