Human Equilibrative Nucleoside Transporter 1 Expression in Endoscopic Ultrasonography-Guided Fine-Needle Aspiration Biopsy Samples Is a Strong Predictor of Clinical Response and Survival in the Patients With Pancreatic Ductal Adenocarcinoma Undergoing Gemcitabine-Based Chemoradiotherapy.

Abstract

OBJECTIVES:

This study aimed to clarify whether pretreatment human equilibrative nucleoside transporter (hENT1) expressions in endoscopic ultrasonography-guided fine-needle aspiration biopsy (EUS-FNAB) specimens obtained from resectable, borderline resectable, and locally advanced unresectable pancreatic ductal adenocarcinoma (PDAC) are concordant with those in the resected specimen after gemcitabine-based chemoradiotherapy (Gem-CRT) and to validate the utility of hENT1 expression using EUS-FNAB samples as a prognostic marker.

METHODS:

We evaluated the relationship between hENT1 expressions assessed by immunohistochemical staining and clinical outcomes in 51 of 76 patients with PDAC who were diagnosed by EUS-FNAB and received preoperative Gem-CRT.

RESULTS:

The concordance rate of hENT1 expressions was 89.2% (K = 0.681). Median survival time (month) in the 51 whole patients and 37 patients with resection was significantly longer in hENT1 positive than in hENT1 negative: 25.0 and 30.0 versus 9.0 and 9.0, respectively. A multivariate analysis confirmed that hENT1 expression was an independent prognostic factor in both whole patients and those with resection. Regardless of T3 and T4, hENT1-positive patients with resection had significantly better prognosis than hENT1-negative patients, whose prognosis was similar to those without resection.

CONCLUSIONS:

The assessment of hENT1 expression using EUS-FNAB samples before Gem-CRT provides important information on patients with PDAC who can benefit from curative-intent resection.

• Authors: Reiko Yamada, Shugo Mizuno, Katsunori Uchida, Misao Yoneda, Kazuki Kanayama, Hiroyuki Inoue, Yasuhiro Murata, Naohisa Kuriyama, Masashi Kishiwada, Masanobu Usui, Noriko Ii, Junya Tsuboi, Shunsuke Tano, Yasuhiko Hamada, Kyosuke Tanaka, Noriyuki Horiki, Toru Ogura, Taizo Shiraishi, Yoshiyuki Takei, Naoyuki Katayama, Shuji Isaji
• Journal: Pancreas (Pancreas) 2016 May-Jun Vol. 45 Issue 5 Pg. 761-71 ISSN: 1536-4828 [Electronic] United States
• PMID: 26784908 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• Equilibrative Nucleoside Transporter 1
• Radiation-Sensitizing Agents
• Deoxycytidine
• Gemcitabine

Topics

• Aged
• Biomarkers, Tumor (biosynthesis)
• Carcinoma, Pancreatic Ductal (metabolism, pathology, therapy)
• Chemoradiotherapy (methods)
• Deoxycytidine (analogs & derivatives, therapeutic use)
• Endoscopic Ultrasound-Guided Fine Needle Aspiration
• Equilibrative Nucleoside Transporter 1 (biosynthesis)
• Female
• Humans
• Immunohistochemistry
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Multivariate Analysis
• Outcome Assessment, Health Care (methods, statistics & numerical data)
• Pancreas (drug effects, pathology, radiation effects)
• Pancreatic Neoplasms (metabolism, pathology, therapy)
• Prognosis
• Proportional Hazards Models
• Radiation-Sensitizing Agents (therapeutic use)
• Gemcitabine