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Low-Level Expression of Smad7 Correlates with Lymph Node Metastasis and Poor Prognosis in Patients with Pancreatic Cancer

  • Hepatobiliary and Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Whether Smad7 acts as a tumor proliferation promoting factor or as a metastatic suppressor in human pancreatic cancer remains unclear. This study aims to determine the prognostic value of Smad7 in patients with pancreatic adenocarcinoma.

Methods

Surgical specimens obtained from 71 patients with pancreatic adenocarcinoma were immunohistochemically assessed for Smad7, Ki-67, MMP2, CD34, and Smad4 expression. The relationship between Smad7 expression and the clinicopathological characteristics of patients with pancreatic adenocarcinoma were also evaluated.

Results

Fifty-one of 71 specimens (71.8%) were Smad7 positive and 20 specimens were Smad7 negative. Negative expression of Smad7 correlated with lymph node metastasis, liver metastasis after surgery, and a poor survival rate (P = 0.0004, 0.0044, and 0.0003, respectively). We also found an inverse correlation between the expression of Smad7 and MMP2 (P = 0.0189). Multivariate analysis revealed that Smad7 expression was an independent prognostic factor [hazard ratio (HR) 0.3902; 95% confidence interval (CI) 0.1839–0.8277; P = 0.0142]. Furthermore, in both Smad4-negative and Smad4-positive groups, survival of patients with Smad7-positive tumors was significantly better than those with Smad7-negative tumors (both P < 0.0001).

Conclusions

We conclude that low-level expression of Smad7 in pancreatic cancer is significantly associated with lymph node metastasis, high MMP2 expression, and poor prognosis.

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Acknowledgement

This study was supported by the “Climbing Up” Project of Shanghai Municipal Commission for Science and Technology, Shanghai, China, grant number GJ-KW0601.

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Authors and Affiliations

  1. Department of Hepatobiliary and Pancreatic Oncology, Cancer Hospital, Fudan University, 270 Dong An Road, Shanghai, China

    Peng Wang MD, Zhen Chen MD, Zhi-Qiang Meng MD, Jun-Hua Lin MD, Zhen-Hua Zhou MD, Hao Chen MD, Kun Wang MD & Lu-Ming Liu MD

  2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China

    Peng Wang MD, Zhen Chen MD, Zhi-Qiang Meng MD, Jian-Min Luo PhD, Jun-Hua Lin MD, Zhen-Hua Zhou MD, Hao Chen MD, Kun Wang MD & Lu-Ming Liu MD

  3. Department of Pathology, Huashan Hospital, Fudan University, Shanghai, China

    Jie Fan MD & Zu-De Xu MD

  4. Central Laboratory, Cancer Hospital/Cancer Institute, Fudan University, Shanghai, China

    Jian-Min Luo PhD

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  1. Peng Wang MD
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Correspondence to Lu-Ming Liu MD.

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Peng Wang and Jie Fan contributed equally to this work.

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Wang, P., Fan, J., Chen, Z. et al. Low-Level Expression of Smad7 Correlates with Lymph Node Metastasis and Poor Prognosis in Patients with Pancreatic Cancer. Ann Surg Oncol 16, 826–835 (2009). https://doi.org/10.1245/s10434-008-0284-5

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  • DOI: https://doi.org/10.1245/s10434-008-0284-5

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