A and B Glycosiltransferase/Blood Group Antigens in Human Pancreatic Ductal Adenocarcinomas.
Adriana Handra-Luca, SeungMo Hong, Ralph Hruban, Michael Goggins. The Johns Hopkins Medical Institutions, Baltimore, MD; APHP Universite Paris 13/Nord UFR SMBH, Bondy Bobigny, France
Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of digestive cancer-related mortality. Recent studies suggested that patients with blood group non-O have increased risk of development of pancreatic cancers. However, information regarding blood group antigen expression in PDACs is limited.
Design: The aim of this study was to determine the clinicopathological significance of blood group expression patterns in patients with resectable PDAC.
459 patients with PDAC were analyzed for immunohistochemical expression of A and B blood group antigens on tissue microarrays. Correlations were established by Fisher's, chi squared tests, and logistic regression models; relationships to overall survival were analyzed by Kaplan-Meier method, logrank test and multivariate Cox models.
Results: The A blood group antigen was expressed in 43% tumors and B antigen in 13%. Blood group antigen expression in normal pancreatic acini was directly correlated to the corresponding patient's blood group type. Tumor A antigen expression correlated (p=0.01) and predicted a decreased number of lymph node metastases (<3, 3 being the median of metastatic lymph nodes) (p<0.01 HR 0.56, 95% CI 0.37-0.85). Tumor A antigen expression was related to a better survival on univariate (p=0.04) and multivariate analysis (p=0.03, HR 0.77 95% CI 0.62-0.97). Blood group serology was not associated with outcome.
Aberrant tumor expression patterns (defined as compared to the patient's blood group type), present in 24% of the tumors, consisted in loss of expression and de novo expression (19% and 5% of the 356 patients with available blood group type).
Loss of A antigen tumor expression (in A blood group type patients) correlated with vascular invasion (p=0.01).
Conclusions: The results of our study suggest that in patients with PDAC:
- Tumor expression of A blood group antigen correlated to <3 lymph node metastases and to a better outcome,
- Loss of tumor A antigen expression correlated to vascular invasion in patients with A blood group type.
Category: Liver & Pancreas
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 208, Tuesday Afternoon