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Exposure to Blood Components and Inflammation Contribute to Pancreatic Cancer Progression

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

Abstract

Background

Pancreatectomy is a highly invasive procedure with extensive intraoperative blood loss (IBL) and high risk of postoperative pancreatic fistula (POPF). We conducted an experimental and retrospective clinical study to determine whether the malignant behaviors of pancreatic cancer cells were enhanced by exposure to blood components in vitro and to evaluate the oncological significance of high IBL and POPF in pancreatic cancer.

Methods

This study included 107 patients undergoing radical pancreatectomy in the University of Yamanashi Hospital between 2011 and 2017, classified into high (n = 29) and low (n = 78) IBL groups. In vitro experiments included functional analyses of Panc-1 pancreatic cancer and normal mesothelial cells exposed to patient blood components, and clinical data were used to assess the contribution of IBL and POPF to patient outcomes.

Results

The migration (p = 0.007), invasion (p < 0.001), and proliferation (p < 0.01) of Panc-1 cells were enhanced with platelet coculture. The ability of Panc-1 cells to adhere mesothelial cells was enhanced by plasma coincubation, especially in the presence of inflammation (p < 0.001). High IBL was associated with worse overall survival (p = 0.007) and increased locoregional recurrence (p = 0.003) in patients. POPF enhanced the negative prognostic significance of high IBL (p < 0.001 for overall survival, p = 0.001 for locoregional recurrence), indicating the oncological negative effects of high IBL and POPF.

Conclusions

Blood components, especially platelets, and inflammation enhance the malignant behaviors of pancreatic cancer cells, potentially contributing to poor prognosis for pancreatic cancer patients.

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Acknowledgments

This study was performed mainly with expenses grants of University of Yamanashi, and partially supported by JSPS KAKENHI (20K17642). The data sets used and analyzed in this study are collected at the University of Yamanashi, and they are available from the corresponding author on reasonable request. Most of them are included in this paper. The authors are grateful to Ms. Arisa Ogihara (University of Yamanashi, Yamanashi, Japan) for their expert technical assistance. The authors thank Editage for the English language reviews.

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Authors and Affiliations

  1. First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Chuo, Yamanashi, Japan

    Ryo Saito MD, PhD, Hiromichi Kawaida MD, PhD, Naohiro Hosomura MD, PhD, Hidetake Amemiya MD, PhD, Jun Itakura MD, PhD, Atsushi Yamamoto MD, PhD, Koichi Takiguchi MD, PhD, Suguru Maruyama MD, PhD, Katsutoshi Shoda MD, PhD, Shinji Furuya MD, PhD, Hidenori Akaike MD, PhD, Yoshihiko Kawaguchi MD, PhD, Makoto Sudo MD, PhD, Shingo Inoue MD, PhD, Hiroshi Kono MD, PhD & Daisuke Ichikawa MD, PhD

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  1. Ryo Saito MD, PhD
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  2. Hiromichi Kawaida MD, PhD
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Correspondence to Daisuke Ichikawa MD, PhD.

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Saito, R., Kawaida, H., Hosomura, N. et al. Exposure to Blood Components and Inflammation Contribute to Pancreatic Cancer Progression. Ann Surg Oncol 28, 8263–8272 (2021). https://doi.org/10.1245/s10434-021-10250-4

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