Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Chin Med J (Engl). 2018 Dec 20;131(24):2947-2952. doi: 10.4103/0366-6999.247211.
Plasminogen activator inhibitor 1 (PAI-1) was previously established to impact several phenotypes in many kinds of cancer, including pancreatic cancer. However, its prognostic significance in pancreatic ductal adenocarcinoma (PDAC) needs support of further evidence. This study was designed to address the issue.
PAI-1 expression was detected by tissue microarray-based immunohistochemical staining in formalin-fixed paraffin-embedded specimens from 93 PDAC patients with surgical resection from September 2004 to December 2008. Its relationships with clinicopathologic variables and tumor-specific survival (TSS) were further evaluated using Chi-square, Kaplan-Meier, log-rank, as well as Cox regression analyses.
Expression of PAI-1 was much higher in tumor than that in nontumor tissues, based on comparison of all samples and 74 matched ones (95 [47.5, 180] vs. 80 [45, 95], Z = -2.439, P = 0.015 and 100 [46.9, 182.5] vs. 80 [45, 95], Z = -2.594, P = 0.009, respectively). In addition, tumoral PAI-1 expression was positively associated with N stage (22/35 for N1 vs. 21/51 for N0, χ = 3.903, P = 0.048). Univariate analyses showed that TSS of patients with high PAI-1 tumors was significantly poorer than that of those with low PAI-1 tumors (log rank value = 19.00, P < 0.0001). In multivariate Cox regression test, PAI-1 expression was identified as an independent predictor for long-term prognosis of resectable PDAC (hazard ratio = 2.559, 95% confidence interval = 1.499-4.367, P = 0.001).
These results suggest that expression of PAI-1 is upregulated in PDAC and might serve as a poor prognostic indicator.
纤溶酶原激活物抑制剂 1（PAI-1）先前已被证实可影响多种癌症的多种表型，包括胰腺癌。然而，其在胰腺导管腺癌（PDAC）中的预后意义仍需要更多证据支持。本研究旨在解决这一问题。
采用组织微阵列免疫组织化学染色法检测 93 例 2004 年 9 月至 2008 年 12 月接受手术切除的 PDAC 患者福尔马林固定石蜡包埋标本中的 PAI-1 表达情况。进一步通过卡方检验、Kaplan-Meier 分析、log-rank 检验和 Cox 回归分析评估其与临床病理变量和肿瘤特异性生存（TSS）的关系。
所有样本和 74 例配对样本中，肿瘤组织中 PAI-1 的表达均明显高于非肿瘤组织（95[47.5，180]与 80[45，95]，Z=-2.439，P=0.015 和 100[46.9，182.5]与 80[45，95]，Z=-2.594，P=0.009）。此外，肿瘤中 PAI-1 的表达与 N 分期呈正相关（35 例 N1 中 22 例 vs. 51 例 N0 中 21 例，χ=3.903，P=0.048）。单因素分析显示，高 PAI-1 肿瘤患者的 TSS 明显差于低 PAI-1 肿瘤患者（对数秩检验值=19.00，P＜0.0001）。多因素 Cox 回归检验显示，PAI-1 表达是可切除 PDAC 患者长期预后的独立预测因子（风险比=2.559，95%置信区间=1.499-4.367，P=0.001）。
这些结果表明，PAI-1 在 PDAC 中表达上调，可能作为预后不良的指标。
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