Annals of Surgical Oncology

, Volume 14, Issue 12, pp 3527–3533

Epithelial-Mesenchymal Transition (EMT) and Activated Extracellular Signal-regulated Kinase (p-Erk) in Surgically Resected Pancreatic Cancer

  • M. M. Javle
  • J. F. Gibbs
  • K. K. Iwata
  • Y. Pak
  • P. Rutledge
  • J. Yu
  • J. D. Black
  • D. Tan
  • T. Khoury
Gastrointestinal Oncology Original Papers

DOI: 10.1245/s10434-007-9540-3

Cite this article as:
Javle, M.M., Gibbs, J.F., Iwata, K.K. et al. Ann Surg Oncol (2007) 14: 3527. doi:10.1245/s10434-007-9540-3

Abstract

Background

EMT or transformation to the mesenchymal phenotype plays an important role in tumor invasion and metastasis. In vitro data suggest that mesenchymal transformation may correlate with the activation of PI3 kinase and Ras/Erk pathways. We investigated the expression of EMT markers (low E-cadherin, high fibronectin, and vimentin) and their association with p-Erk in resected pancreatic cancer.

Methods

Clinical data/surgical specimens from 34 consecutive pancreatic cancer patients (pts) who underwent pancreatectomy were included. Immunohistochemical staining was performed on formalin-fixed paraffin-embedded tissues using monoclonal antibodies against vimentin, fibronectin, E-cadherin, and p-Erk. The results were correlated with clinicopathological parameters and survival. Survival analysis (log-rank test, Cox proportional hazard model), categorical data analysis (Pearson’s chi-square, Fisher’s exact test) and Kendall’s tau were performed at a significance level of 0.05.

Results

The patient population was formed from 13 males and 21 females, with a median age of 66 years (range 38–84 years); American Joint Committee on Cancer (AJCC) stage 1 (n = 2), 2 (n = 27), 3 (n = 5); histological grade 1 (n = 4), 2 (n = 13), 3 (n = 16), 4 (n = 1). Median survival was 15 months (95% CI: 11–24 months). Fibronectin overexpression correlated with the presence of vimentin (p = 0.0048) and activated Erk (p = 0.0264). There was a borderline association of fibronectin with worsening grade (p = 0.06). A negative association between vimentin and E-cadherin was noted (p = 0.0024). Increased fibronectin or vimentin and decreased E-cadherin correlated with poor survival.

Conclusion

EMT is associated with poor survival in surgically resected pancreatic adenocarcinoma. A correlation between activated Erk and fibronectin was identified that may open avenues for targeted therapy for this subgroup.

Keywords

Pancreatic neoplasmsCell transformation-neoplasticMitogen-activated protein kinases

Copyright information

© Society of Surgical Oncology 2007

Authors and Affiliations

  • M. M. Javle
    • 1
  • J. F. Gibbs
    • 2
  • K. K. Iwata
    • 3
  • Y. Pak
    • 4
  • P. Rutledge
    • 3
  • J. Yu
    • 4
  • J. D. Black
    • 5
  • D. Tan
    • 6
  • T. Khoury
    • 7
  1. 1.Department of Gastrointestinal Medical OncologyUT-MD Anderson Cancer CenterHoustonUSA
  2. 2.Departments of SurgeryRoswell Park Cancer InstituteBuffaloUSA
  3. 3.OSI PharmaceuticalsMelvilleUSA
  4. 4.BiostatisticsRoswell Park Cancer InstituteBuffaloUSA
  5. 5.PharmacologyRoswell Park Cancer InstituteBuffaloUSA
  6. 6.PathologyUT-MD Anderson Cancer CenterHoustonUSA
  7. 7.PathologyRoswell Park Cancer InstituteBuffaloUSA