Sugano Hiroshi, Shirai Yoshihiro, Sato Shun, Hamatani Shigeharu, Hamura Ryoga, Taniai Tomohiko, Horiuchi Takashi, Gocho Takeshi, Eto Ken, Ikegami Toru
Department of Surgery The Jikei University School of Medicine Tokyo Japan.
Division of Gene Therapy Research Center for Medical Science The Jikei University School of Medicine Tokyo Japan.
Ann Gastroenterol Surg. 2021 Feb 20;5(4):567-574. doi: 10.1002/ags3.12447. eCollection 2021 Jul.
Pancreatic cancer is one of the most aggressive digestive cancers. The tumor expression of thrombomodulin (TM) is correlated with favorable prognosis in several types of cancer. However, this correlation has not been confirmed in hepato-pancreato-biliary cancer. The aim of this study was to evaluate the prognostic value of TM expression in resected pancreatic ductal adenocarcinoma.
The data of patients who underwent pancreatic resection for pancreatic invasive ductal adenocarcinoma were obtained from a prospectively maintained database. A total of 131 patients were included. Paraffin sections of tumor tissues were stained immunohistochemically using TM antibody. The patients were divided into two groups: the TM-positive or TM-negative group.
The specimens were TM-positive in 72 cases. TM expression was a significant factor of favorable prognosis in univariate analysis for disease-free (DFS) and overall survival (OS). The median OS in the TM-positive patients was 32.9 mo, which was better than the 20.0 mo in TM-negative patients ( =.006). TM positivity retained its significance on multivariate analysis for DFS (hazard ratio [HR] 0.651, 95% confidence interval [CI] 0.433-0.979, =.039) and OS (HR 0.569, 95% CI 0.376-0.862, =.008).
The tumor expression of TM is a favorable factor for OS in resected pancreatic invasive ductal adenocarcinoma.
胰腺癌是侵袭性最强的消化系统癌症之一。血栓调节蛋白（TM）在肿瘤中的表达与多种癌症的良好预后相关。然而，这种相关性在肝胰胆管癌中尚未得到证实。本研究的目的是评估TM表达在切除的胰腺导管腺癌中的预后价值。
从一个前瞻性维护的数据库中获取因胰腺浸润性导管腺癌接受胰腺切除术的患者数据。共纳入131例患者。使用TM抗体对肿瘤组织石蜡切片进行免疫组织化学染色。患者分为两组：TM阳性组或TM阴性组。
72例标本TM呈阳性。在无病生存期（DFS）和总生存期（OS）的单因素分析中，TM表达是良好预后的重要因素。TM阳性患者的中位OS为32.9个月，优于TM阴性患者的20.0个月（P = 0.006）。在DFS的多因素分析中，TM阳性仍具有显著意义（风险比[HR] 0.651，95%置信区间[CI] 0.433 - 0.979，P = 0.039），在OS中也是如此（HR 0.569，95% CI 0.376 - 0.862，P = 0.008）。
TM在肿瘤中的表达是切除的胰腺浸润性导管腺癌OS的有利因素。
