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Strong Membranous Expression of Plectin Is an Independent Predictor of Improved Survival After Resection of Pancreatic Head Ductal Adenocarcinoma
Peter Bronsert*1, Moritz Pross3, Sylvia Timme1, Martin Werner1, Ulrich T. Hopt2, Frank Makowiec2, Dirk Bausch3, Tobias Keck3, Ulrich F. Wellner3
1Institute of Pathology, University Medical Center Freiburg, Freiburg, Germany; 2Clinic for General and Visceral Surgery, University Medical Center Freiburg, Freiburg, Germany; 3Clinic for Surgery, UKSH Campus Lübeck, Lübeck, Germany
Introduction:
Plectin has been proposed as a novel marker of pancreatic ductal adenocarcinoma (PDAC). Cell surface as well as cytosolic localization has been found and suggested to contribute to distinct biological functions. The aim of our study was to evaluate the prognostic value of plectin expression pattern in PDAC.
Methods:
A retrospective study was performed on the basis of a prospectively maintained database. Tissue slides from formalin-fixed paraffin embedded tissue were immunostained for plectin and expression was graded with respect to staining intensity, subcellular location and percentage of tumor positive cells. IBM SPSS Version 21 was used for all calculations with the significance level set to p=0.05.
Results:
N=103 patients with pancreatic head PDAC resected by pancreatoduodenectomy were included. Median percentage of plectin expressing tumor cells was 90%, with strong intensity in 52% of cases, predominantly membranous expression in 21% versus cytosolic or mixed expression in 79%. Strong membranous plectin expression was associated with improved survival compared to strong cytosolic or mixed expression (37 versus 17 months, p<0.05). In a multivariate Cox proportional hazards model, strong membranous plectin expression and lymph node ratio were the only independent predictors of survival.
Conclusion:
Plectin expression was found in all pancreatic head PDAC, with variations in percentage of positive tumor cells, intensity and subcellular location. Strong and predominantly membranous expression of plectin was independently associated with improved survival.
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