Department of Molecular Pathology, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Department of Surgery, Iwate Prefectural Chubu Hospital, Kitakami, Iwate, 024-8507, Japan.
Surg Today. 2023 May;53(5):633-639. doi: 10.1007/s00595-023-02655-3. Epub 2023 Feb 10.
Recent advances in the development of chemotherapies have helped improve the prognosis of pancreatic ductal adenocarcinoma (PDAC). However, predicting factors for the outcomes of chemotherapies (either gemcitabine or S-1) have not yet been established. We analyzed the expression of 4 major epithelial-to-mesenchymal transition-inducing transcription factors in 38 PDAC patients who received adjuvant chemotherapy after radical resection to examine the association with patients' prognoses. The TWIST1-positive group showed a significantly poorer prognosis than the TWIST1-negative group for both the relapse-free survival (median survival time [MST] of 8.9 vs. 18.5 months, P = 0.016) and the overall survival (MST of 15.2 vs. 33.4 months, P = 0.023). A multivariate analysis revealed that TWIST1 positivity was an independent prognostic factor for a poor response to adjuvant chemotherapies (hazard ratio 2.61; 95% confidence interval 1.10-6.79; P = 0.029). These results suggest that TWIST1 can be utilized as an important poor prognostic factor for radically resected PDAC patients with adjuvant chemotherapy, potentially including neoadjuvant therapy using these agents.
近年来，化疗的发展进步有助于改善胰腺导管腺癌（PDAC）的预后。然而，化疗（吉西他滨或 S-1）疗效的预测因素尚未确定。我们分析了 38 例接受根治性切除术后辅助化疗的 PDAC 患者中 4 种主要上皮-间充质转化诱导转录因子的表达，以研究其与患者预后的关系。TWIST1 阳性组的无复发生存（MST 为 8.9 个月 vs. 18.5 个月，P=0.016）和总生存（MST 为 15.2 个月 vs. 33.4 个月，P=0.023）均明显劣于 TWIST1 阴性组。多因素分析显示，TWIST1 阳性是辅助化疗反应不良的独立预后因素（风险比 2.61；95%置信区间 1.10-6.79；P=0.029）。这些结果表明，TWIST1 可作为接受辅助化疗的根治性切除 PDAC 患者的一个重要不良预后因素，可能包括使用这些药物的新辅助治疗。
