title: Inflammatory cells contribute to the generation of an angiogenic phenotype in pancreatic ductal adenocarcinoma.
abstract: BACKGROUND
  Inflammatory cells contribute to the growth and spread of human malignancies by producing molecules that enhance tumour invasiveness.
  
  
  OBJECTIVE
  To characterise the inflammatory infiltrate in pancreatic ductal adenocarcinoma and to analyse its contribution to angiogenesis and its prognostic relevance.
  
  
  METHODS
  Immunohistochemistry was used to identify inflammatory cells and evaluate the expression of proangiogenic and prolymphangiogenic molecules (vascular endothelial growth factor A (VEGF-A), VEGF-C, and basic fibroblast growth factor (bFGF)) by inflammatory and cancer cells in 137 pancreatic cancers. Intratumorous microvessel density (IMD) was assessed using CD34 as an endothelial cell marker.
  
  
  RESULTS
  There were significantly more mast cells and macrophages in pancreatic cancers than in normal pancreas and the number of mast cells directly correlated with the presence of lymph node metastases. However, there was no relation between numbers of infiltrating inflammatory cells and the presence of chronic pancreatitis (CP)-like changes in the parenchyma surrounding the tumour. Double immunostaining revealed that both pancreatic mast cells and macrophages express VEGF-A, VEGF-C, and bFGF. These factors were also expressed in the tumour cells in many cases. The numbers of VEGF-A expressing tumour cells and bFGF expressing tumour and inflammatory cells significantly correlated with IMD. Moreover, tumours with higher IMD had higher numbers of infiltrating mast cells and macrophages.
  
  
  CONCLUSIONS
  Mononuclear inflammatory cells of the non-specific immune response are recruited to pancreatic cancer tissues independent of the presence of CP-like changes, may influence the metastatic capacity of the cancer cells, and may contribute to the development of tumours with high angiogenic activity.
authors.affiliation: Institute of Pathology, University of Heidelberg, 69120 Heidelberg, Germany. irene_esposito@med.uni-heidelberg.de
authors.forename: I
authors.initials: I
authors.lastname: Esposito
authors.forename: M
authors.initials: M
authors.lastname: Menicagli
authors.forename: N
authors.initials: N
authors.lastname: Funel
authors.forename: F
authors.initials: F
authors.lastname: Bergmann
authors.forename: U
authors.initials: U
authors.lastname: Boggi
authors.forename: F
authors.initials: F
authors.lastname: Mosca
authors.forename: G
authors.initials: G
authors.lastname: Bevilacqua
authors.forename: D
authors.initials: D
authors.lastname: Campani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000098:blood supply / Q000378:metabolism / Q000473:pathology* / Q000556:secondary; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008207:Lymphatic Metastasis; D008264:Macrophages / Q000378:metabolism / Q000473:pathology; D008297:Male; D008407:Mast Cells / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000473:pathology*; D010179:Pancreas / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000378:metabolism / Q000473:pathology*; D016019:Survival Analysis; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D042582:Vascular Endothelial Growth Factor C / Q000378:metabolism
chemical_list: D009363:Neoplasm Proteins; C467484:VEGFA protein, human; C467486:VEGFC protein, human; D042461:Vascular Endothelial Growth Factor A; D042582:Vascular Endothelial Growth Factor C; D016222:Fibroblast Growth Factor 2