Published online Oct 28, 2017. doi: 10.3748/wjg.v23.i40.7232
Peer-review started: August 17, 2017
First decision: August 30, 2017
Revised: September 13, 2017
Accepted: September 20, 2017
Article in press: September 19, 2017
Published online: October 28, 2017
Processing time: 73 Days and 19.1 Hours
To investigate the relationship between autophagy and perineural invasion (PNI), clinical features, and prognosis in patients with pancreatic cancer.
Clinical and pathological data were retrospectively collected from 109 patients with pancreatic ductal adenocarcinoma who underwent radical resection at the First Affiliated Hospital of Zhengzhou University from January 2011 to August 2016. Expression levels of the autophagy-related protein microtubule-associated protein 1A/1B-light chain 3 (LC3) and PNI marker ubiquitin carboxy-terminal hydrolase (UCH) in pancreatic cancer tissues were detected by immunohistochemistry. The correlations among LC3 expression, PNI, and clinical pathological features in pancreatic cancer were analyzed. The patients were followed for further survival analysis.
In 109 cases of pancreatic cancer, 68.8% (75/109) had evidence of PNI and 61.5% (67/109) had high LC3 expression. PNI was associated with lymph node metastasis, pancreatitis, and CA19-9 levels (P < 0.05). LC3 expression was related to lymph node metastasis (P < 0.05) and was positively correlated with neural invasion (P < 0.05, r = 0.227). Multivariate logistic regression analysis indicated that LC3 expression, lymph node metastasis, pancreatitis, and CA19-9 level were factors that influenced neural invasion, whereas only neural invasion itself was an independent factor for high LC3 expression. Univariate analysis showed that LC3 expression, neural invasion, and CA19-9 level were related to the overall survival of pancreatic cancer patients (P < 0.05). Multivariate COX regression analysis indicated that PNI and LC3 expression were independent risk factors for poor prognosis in pancreatic cancer (P < 0.05).
PNI in patients with pancreatic cancer is positively related to autophagy. Neural invasion and LC3 expression are independent risk factors for pancreatic cancer with a poor prognosis.
Core tip:The relationship between autophagy and perineural invasion (PNI) was explored for the first time in pancreatic cancer. Pancreatic cancer PNI is related to microtubule-associated protein 1A/1B-light chain 3 (LC3) expression-determined autophagy. PNI and LC3 expression were independent prognostic factors in pancreatic cancer. There might be a special association between autophagy and PNI, which contributes to pancreatic cancer progression. This study might provide a new insight for the mechanism of PNI in pancreatic cancer.