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Maximum Standard Uptake Value as a Clinical Biomarker for Detecting Loss of SMAD4 Expression and Early Systemic Tumor Recurrence in Resected Left-Sided Pancreatic Cancer

 Chang Moo Kang  ;  Ho Kyoung Hwang  ;  Jiae Park  ;  Changsoo Kim  ;  Seong-Kyoung Cho  ;  Mijin Yun  ;  Woo Jung Lee 
 MEDICINE, Vol.95(17) : 3452, 2016 
Journal Title
Issue Date
Aged ; Biomarkers, Tumor/genetics* ; Female ; Fluorodeoxyglucose F18 ; Gene Silencing* ; Humans ; Male ; Middle Aged ; Multimodal Imaging ; Neoplasm Recurrence, Local/diagnosis* ; Neoplasm Recurrence, Local/genetics* ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/pathology ; Pancreas/diagnostic imaging ; Pancreas/pathology ; Pancreatectomy* ; Pancreatic Neoplasms/genetics* ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery* ; Positron-Emission Tomography ; Predictive Value of Tests ; Prognosis ; Smad4 Protein/genetics* ; Statistics as Topic ; Survival Analysis ; Tomography, X-Ray Computed
This study investigated the oncologic impact of loss of SMAD4 expression in resected left-sided pancreatic cancer and its correlation with tumor metabolism.From 2005 to 2011, the medical records of patients who underwent radical distal pancreatectomy for resectable pancreatic cancer were retrospectively reviewed. Formalin-fixed, paraffin embedded tissue from 32 patients was investigated. Clinicopathological characteristics, immunostaining of SMAD4, and positron emission tomography-based parameters were analyzed in relation to oncologic outcomes.Thirteen patients were women and 19 were men, with a mean age of 63 ± 9.4 years. Mean resected tumor size was 3.3 ± 1.5 cm. Ten patients (31.3%) showed loss of SMAD4 expression. No significant clinicopathological differences were noted according to SMAD4 expression (P > 0.05); however, patients with loss of SMAD4 showed significantly poorer disease-free survival (mean 57.4 months vs mean 17.6 months, P = 0.006). As a cut-off value, a SUVmax of 4.5 was found to be predictive of loss of SMAD4 with a sensitivity of 75% and a specificity of 84.6%. In logistic regression analysis, SUVmax>4.5 was found to infer a 16-fold higher risk for loss of SMAD4 in resected left-sided pancreatic cancers (Exp[β] = 16.5, P = 0.012, 95% confidence interval: 1.832-148.606).Loss of SMAD4 is associated with poor oncologic outcomes. SUVmax can predict loss of SMAD4 in resected left-sided pancreatic cancer. SUVmax may be a clinical biomarker for detecting loss of SMAD4 expression and predicting early systemic metastasis.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Chang Soo(김창수) ORCID logo https://orcid.org/0000-0002-5940-5649
Park, Jiae(박지애)
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Cho, Seong-Kyung(조성경)
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
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