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Background
Gemcitabine is promising adjuvant chemotherapy for patients with resected pancreatic cancer. Human equilibrative nucleotide transporter-1 (hENT1) is the major transporter responsible for gemcitabine uptake into cells. The aim of the current study is to investigate whether hENT1 expression can predict the survival of pancreatic cancer patients treated with adjuvant gemcitabine-based chemotherapy after pancreatic resection.
Methods
Immunohistochemical hENT1 expression was analyzed in 19 resected pancreatic cancer patients received gemcitabine-based adjuvant chemotherapy. Relationships between various clinicopathological factors including hENT1 expression and patient survival were examined using univariate and multivariate analysis.
Results
Sixteen (84%) patients highly expressed hENT1.Patients with low expression of hENT1 showed significantly worth outcome than high expression group [2-year survival: 0% for low expression group vs. 60% for high expression group; HR 8.72, 95% confidence interval (CI) 1.70-44.76, p=0.009] (Figure), although low hENT1 expression was not independent prognostic factor by multivariate analysis (HR 4.41, 95% CI 0.71-27.39, p=0.111). Other prognostic factor was only AJCC stage [2-year survival 0% (III, IV) vs. 64% (I, II), HR 6.24, 95% CI 1.35-28.85, p=0.0192]. Tumor size, lymph node metastasis, and residual tumor (R1 vs R0) did not reach significant prognostic factor, although the trend was observed.
Conclusions
Low expression of hENT1 strongly indicated worth outcome of patients treated with adjuvant gemcitabine-based chemotherapy after pancreatic resection. Gemcitabine-based adjuvant chemotherapy may be useful for only high expression of hENT1. The new adjuvant chemotherapy except gemcitabine might be necessary for patients with low expression of hENT1.