title: Syndecan-1 expression--a novel prognostic marker in pancreatic cancer.
abstract: OBJECTIVE
  Syndecan-1 is a transmembrane receptor that participates in cell-cell and cell-matrix interactions, cell proliferation and cell migration. Expression of syndecan-1 is downregulated in many cancers, but in pancreatic ductal adenocarcinoma it is upregulated.
  
  
  METHODS
  We studied the immunohistochemical expression of syndecan-1 in 144 pancreatic adenocarcinomas and evaluated the prognostic value of syndecan-1 expression. Formalin-fixed, paraffin-embedded specimens were stained with mouse monoclonal antibody B-B4 against human syndecan-1. The epithelial and stromal staining was separately evaluated and compared with patient survival, clinical stage and histological grade.
  
  
  RESULTS
  Epithelial immunoreactivity was observed in most of the pancreatic carcinoma samples: in 70 (49%) of the samples the epithelial staining was weak, in 48 (33%) moderate, in 18 (12%) strong and in only 8 (6%) of the samples the epithelial staining was negative. Stromal staining was weak in 24 (17%), moderate in 31 (22%), strong in 11 (8%) and negative in 78 (54%) of the pancreatic carcinoma samples. Lack of stromal expression predicted a better prognosis (p = 0.002; HR 1.7) and it was independent of stage (p = 0.01; HR = 1.5) and grade (p = 0.0004; HR 2.1) in multivariate analysis. Epithelial expression predicted better prognosis for patients that underwent surgery for cure (n = 94, p = 0.03).
  
  
  CONCLUSIONS
  Stromal syndecan-1 expression is an independent prognostic marker in pancreatic cancer, whereas epithelial syndecan-1 expression predicts better prognosis only in resectable disease.
authors.affiliation: Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Juuti
authors.forename: Stig
authors.initials: S
authors.lastname: Nordling
authors.forename: Johan
authors.initials: J
authors.lastname: Lundin
authors.forename: Johanna
authors.initials: J
authors.lastname: Louhimo
authors.forename: Caj
authors.initials: C
authors.lastname: Haglund
mesh_terms: D000208:Acute Disease; D000368:Aged; D000704:Analysis of Variance; D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000276:immunology; D021441:Carcinoma, Pancreatic Ductal / Q000737:chemistry* / Q000473:pathology; D002908:Chronic Disease; D004847:Epithelial Cells / Q000737:chemistry; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis* / Q000276:immunology; D008875:Middle Aged; D010179:Pancreas / Q000737:chemistry; D010190:Pancreatic Neoplasms / Q000737:chemistry* / Q000473:pathology; D010195:Pancreatitis / Q000378:metabolism; D011237:Predictive Value of Tests; D011379:Prognosis; D011509:Proteoglycans / Q000032:analysis* / Q000276:immunology; D012189:Retrospective Studies; D017154:Stromal Cells / Q000737:chemistry; D053668:Syndecan-1; D053667:Syndecans; D015854:Up-Regulation
chemical_list: D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D008562:Membrane Glycoproteins; D011509:Proteoglycans; C508241:SDC1 protein, human; C508242:Sdc1 protein, mouse; D053668:Syndecan-1; D053667:Syndecans