Yang HY, Chong JU, Jang M, Lee SH, Hwang HK, Lee WJ, Kang CM. Stromal secreted protein acidic and rich in cysteine expression: A potential target for improved prognosis in patients with pancreatic cancer. World J Gastrointest Oncol 2025; 17(11): 110704 [DOI: 10.4251/wjgo.v17.i11.110704]
Corresponding Author of This Article
Chang Moo Kang, MD, PhD, Professor, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea. cmkang@yuhs.ac
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Gastroenterology & Hepatology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 15, 2025 (publication date) through Nov 13, 2025
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World Journal of Gastrointestinal Oncology
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Yang HY, Chong JU, Jang M, Lee SH, Hwang HK, Lee WJ, Kang CM. Stromal secreted protein acidic and rich in cysteine expression: A potential target for improved prognosis in patients with pancreatic cancer. World J Gastrointest Oncol 2025; 17(11): 110704 [DOI: 10.4251/wjgo.v17.i11.110704]
World J Gastrointest Oncol. Nov 15, 2025; 17(11): 110704 Published online Nov 15, 2025. doi: 10.4251/wjgo.v17.i11.110704
Stromal secreted protein acidic and rich in cysteine expression: A potential target for improved prognosis in patients with pancreatic cancer
Hye Yeon Yang, Jae Uk Chong, Mi Jang, Sung Hwan Lee, Ho Kyoung Hwang, Woo Jung Lee, Chang Moo Kang
Hye Yeon Yang, Department of Surgery, Ajou University School of Medicine, Suwon 16499, South Korea
Jae Uk Chong, Department of Surgery, National Health Insurance Services Ilsan Hospital, Goyang 10444, South Korea
Mi Jang, Department of Pathology, National Health Insurance Services Ilsan Hospital, Goyang 10444, South Korea
Sung Hwan Lee, Department of Surgery, CHA University, Bundang 13497, South Korea
Ho Kyoung Hwang, Woo Jung Lee, Chang Moo Kang, Department of Surgery, Yonsei University College of Medicine, Seoul 03722, South Korea
Co-first authors: Hye Yeon Yang and Jae Uk Chong.
Author contributions: Yang HY, Chong JU, and Kang CM designed the study and obtained the data; Yang HY, Chong JU, Jang M, and Lee SH analyzed data, interpreted the data and results; Yang HY and Chong JU drafted the manuscript and made equal contributions as co-first authors; Yang HY, Lee SH, Kang CM, Hwang HK, and Lee WJ revised the manuscript for intellectual content; all authors contributed significantly to and agree with the content of the manuscript.
Supported by Faculty Research Grant from Yonsei University College of Medicine, No. 6-2017-0155.
Institutional review board statement: This study was approved by the Institutional Review Board of Severance Hospital, No. 4-2017-1029.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chang Moo Kang, MD, PhD, Professor, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea. cmkang@yuhs.ac
Received: June 16, 2025 Revised: July 24, 2025 Accepted: September 30, 2025 Published online: November 15, 2025 Processing time: 154 Days and 17.9 Hours
Abstract
BACKGROUND
Pancreatic cancer tissues mainly consist of fibrotic and dense stroma, which limits their therapeutic efficacy. The stromal fibroblasts of pancreatic tumors frequently express the secreted protein acidic and rich in cysteine (SPARC).
AIM
To assess the impact of SPARC and its oncological relevance in patients undergoing pancreatic cancer resection.
METHODS
Ninety-one pancreatic ductal adenocarcinoma specimens were obtained from patients with curative resection between January 2009 and December 2015 as a retrospective study. SPARC expression patterns were analyzed using immunohistochemistry. Oncological outcomes were analyzed based on SPARC expression patterns. Oncological outcomes, based on SPARC expression, were analyzed in The Cancer Genome Atlas-Pancreatic Adenocarcinoma cohort (retrieved from a public database).
RESULTS
Patients with stromal SPARC expression (sSPARC+) had poorer overall survival than that in those without it (sSPARC-) (P = 0.035). However, among patients who received adjuvant treatment, no difference was observed in survival between the sSPARC+ and the sSPARC- groups (P = 0.14). In The Cancer Genome Atlas-Pancreatic Adenocarcinoma samples, the high SPARC expression group exhibited noticeably lower overall survival than that in the low expression group (cutoff: 14.1295, P = 0.0222). Furthermore, SPARC expression was strongly correlated with the percentage the CD10+ stromal component (R2 = 0.804, P < 0.001).
CONCLUSION
Adjuvant chemotherapy improves survivals in sSPARC+ pancreatic cancer patients, indicating suggesting sSPARC expression as a prognostic biomarker and potential indicator for neoadjuvant treatment planning.
Core Tip: This retrospective study investigated the prognostic significance of stromal secreted protein acidic and rich in cysteine (SPARC) expression in resected pancreatic ductal adenocarcinoma. High stromal SPARC expression is associated with inferior recurrence-free and overall survival, particularly in patients without adjuvant chemotherapy. External validation using The Cancer Genome Atlas-Pancreatic Adenocarcinoma cohort further supported the association between unfavorable prognosis and high SPARC expression. These findings suggest that stromal SPARC may serve as a meaningful prognostic biomarker and potential therapeutic target for pancreatic ductal adenocarcinoma.
