Prognostic significance of molecular alterations in human pancreatic carcinoma - an immunohistological study

Background: During the last decade, many molecular alterations have been described for pancreatic carcinomas. However, the clinical and prognostic value of these alterations has been discussed and is controversial. Methods: An immunhistochemical study was performed in 82 cases of adenocarcinoma of the pancreas. Using specific antibodies, expression of EGF, EGF-receptor, cERB-B2, p53, p21(CIP1), cyclin-D1, BCL-2, CD95 and KI67 was evaluated. Results: Overexpression of the different molecules was found in 44-69% of the pancreatic carcinomas. With regard to clinico-pathological features, p53 positivity was more frequently found in advanced and undifferentiated rumours (P<0.05), EGF overexpression was significantly more frequent in advanced rumours (P<0.05) and CD95 overexpression was observed to a greater extent in undifferentiated tumours (P<0.05). Besides cyclin-D1, none of the molecules tested was of prognostic significance. Patients whose rumours expressed cyclin-D1 lived significantly shorter than patients with cyclin-D1-negative rumours. However, in subgroup analyses of patients with the same tumour stage or tumour grade, even cyclin-D1 expression had no prognostic significance. Conclusion: These results demonstrate that the prognostic significance of the molecules tested here is low. Nevertheless, with regard to tumorigenesis and tumour biology of pancreatic carcinoma, determination of molecular alterations could provide important information about pancreatic cancer.