Tumour necrosis is a postoperative prognostic marker for pancreatic cancer patients with a high interobserver reproducibility in histological evaluation
Open Access
- 24 August 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in British Journal of Cancer
- Vol. 103 (7), 1057-1065
- https://doi.org/10.1038/sj.bjc.6605854
Abstract
Tumour necrosis reflects the presence of hypoxia, which can be indicative of an aggressive tumour phenotype. The aim of this study was to investigate whether histological necrosis is a useful predictor of outcome in patients with pancreatic ductal carcinoma (PDC). We reviewed histopathological findings in 348 cases of PDC in comparison with clinicopathological information. We counted small necrotic foci (micronecrosis) as necrosis, in addition to massive necrosis that had been only defined as necrosis in previous studies. The reproducibility of identifying histological parameters was tested by asking five independent observers to blindly review 51 examples of PDC. Both micronecrosis and massive necrosis corresponded to hypoxic foci expressing carbonic anhydrase IX detected by immunohistochemistry. Multivariate survival analysis showed that histological necrosis was an independent predictor of poor outcome in terms of both disease-free survival (DFS) and disease-specific survival (DSS) of PDC patients. In addition, metastatic status, and lymphatic, venous, and intrapancreatic neural invasion were independent prognostic factors for shorter DFS and metastatic status, margin status, lymphatic invasion, and intrapancreatic neural invasion were independent prognostic factors for DSS. The interobserver reproducibility of necrosis identification among the five independent observers was ‘almost perfect’ (κ-value of 0.87). Histological necrosis is a simple, accurate, and reproducible predictor of postoperative outcome in PDC patients.Keywords
This publication has 70 references indexed in Scilit:
- Mannose-binding lectin and its associated proteases (MASPs) mediate coagulation and its deficiency is a risk factor in developing complications from infection, including disseminated intravascular coagulationImmunobiology, 2010
- Mannan‐binding lectin deficiency modulates the humoral immune response dependent on the genetic environmentImmunology, 2009
- Deficiency of mannose-binding lectin greatly increases antibody response in a mouse model of vaccinationClinical Immunology, 2009
- Burn Injury Reveals Altered Phenotype in Mannan-Binding Lectin-Deficient MiceJournal of Investigative Dermatology, 2007
- Leptin Resistance Protects Mice from Hyperoxia-induced Acute Lung InjuryAmerican Journal of Respiratory and Critical Care Medicine, 2007
- Influenza Virus PB1-F2 Protein Induces Cell Death through Mitochondrial ANT3 and VDAC1PLoS Pathogens, 2005
- Assembly and budding of influenza virusVirus Research, 2004
- Hypoxia — a key regulatory factor in tumour growthNature Reviews Cancer, 2002
- Phylogenetic Perspectives in Innate ImmunityScience, 1999
- INHIBITORY AND INACTIVATING ACTION OF NORMAL FERRET SERA AGAINST AN INFLUENZA VIRUS STRAINImmunology & Cell Biology, 1946