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Open Access 01-12-2021 | Pancreatic Cancer | Research article

Pancreatic cancer stem cells may define tumor stroma characteristics and recurrence patterns in pancreatic ductal adenocarcinoma

Authors: Gokce Askan, Ibrahim Halil. Sahin, Joanne F. Chou, Aslihan Yavas, Marinela Capanu, Christine A. Iacobuzio-Donahue, Olca Basturk, Eileen M. O’Reilly

Published in: BMC Cancer | Issue 1/2021

Abstract

Background

Herein, we investigate the relationship between pancreatic stem cell markers (PCSC markers), CD44, and epithelial-specific antigen (ESA), tumor stroma, and the impact on recurrence outcomes in pancreatic ductal adenocarcinoma (PDAC) patients.

Methods

PDAC patients who underwent surgical resection between 01/2012–06/2014 were identified. CD44 and ESA expression was assessed by immunohistochemistry. Stroma was classified as loose, moderate, and dense based on fibroblast content. Overall survival (OS) and relapse-free survival (RFS) were estimated using the Kaplan-Meier method and compared between subgroups by log-rank test. The association between PCSC markers and stroma type was assessed by Fisher’s exact test.

Results

N = 93 PDAC patients were identified. The number of PDAC patients with dense, moderate density, and loose stroma was 11 (12%), 51 (54%), and 31 (33%) respectively. PDAC with CD44⁺/ESA⁻ had highest rate of loose stroma (63%) followed by PDAC CD44⁺/ESA⁺ (50%), PDAC CD44^−/ESA⁺ (35%), CD44^−/ESA⁻ (9%) (p = 0.0033). Conversely, lack of CD44 and ESA expression was associated with the highest rate of moderate and dense stroma (91% p = 0.0033). No local recurrence was observed in patients with dense stroma and 9 had distant recurrence. The highest rate of cumulative local recurrence was observed in patients with loose stroma. No statistically significant difference in RFS and OS was observed among subgroups (P = 0.089).

Conclusions

These data indicate PCSCs may have an important role in stroma differentiation in PDAC. Our results further suggest that tumor stroma may influence the recurrence pattern in PDAC patients.

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Title: Pancreatic cancer stem cells may define tumor stroma characteristics and recurrence patterns in pancreatic ductal adenocarcinoma
Authors: Gokce Askan
Ibrahim Halil. Sahin
Joanne F. Chou
Aslihan Yavas
Marinela Capanu
Christine A. Iacobuzio-Donahue
Olca Basturk
Eileen M. O’Reilly
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Pancreatic Cancer
Pancreatic Cancer
Published in: BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-021-08123-w

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Abstract

Background

Methods

Results

Conclusions

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