title: Stromal SPARC expression and patient survival after chemoradiation for non-resectable pancreatic adenocarcinoma.
abstract: OBJECTIVE
  Pancreatic stellate cells (PSC) drive desmoplasia in pancreatic cancer. Our study analyzed both tumor and PSC, since interaction of these cell types may promote tumor progression.
  
  
  RESULTS
  SPARC was expressed predominantly in the peritumoral and distal stroma. SPARC in distal stroma correlated inversely with overall survival of the patients with LAPC (p = 0.013) with a relative hazard of 2.23 (95% CI, 1.05 to 4.72; p = 0.036). TGFbeta1 in the tumor was also a negative prognostic factor (p = 0.03). Within the tumor cells, phospho-Akt correlated with TGFbeta1, SPARC and survivin. Tumor phospho-Akt correlated with stroma phospho-Akt, tumor TGFbeta1 correlated with stroma TGFbeta1 and alpha-SMA, tumor survivin correlated with stroma survivin and distal SPARC. Within the stroma, SPARC and TGFbeta1 correlated with alpha-SMA. Peritumoral SPARC correlated with distal SPARC. In vitro, SPARC was highly expressed in hPSC but not in Panc-1 cells. Exogenous SPARC did not change radiation resistance but increased the invasion of Panc-1 cells both in monoculture and in coculture with hPSC.
  
  
  METHODS
  Immunohistochemical expression of SPARC, CTGF, TGFbeta1, phospho-Akt, survivin and alpha-SMA was analyzed prior to chemoradiation in 58 locally advanced pancreatic cancer (LAPC) biopsy specimens. Fisher's exact test served to detect associations between tumor and PSC expression of markers. Kaplan-Meier analysis and multivariate analysis were used to evaluate the association of marker expression with overall survival. SPARC expression was analyzed in human pancreatic cancer cells (Panc-1) and in human PSC (hPSC) and the effect of SPARC on the invasion of Panc-1 cells was measured in monoculture or in coculture with hPSC.
  
  
  CONCLUSIONS
  Our hypothesis of a detrimental effect of PSC on patient survival in LAPC after chemoradiation is supported by the inverse correlation of SPARC in distal stromal cells with patients survival. Furthermore in vitro data indicate that paracrine SPARC from PSC increases the invasion of pancreatic cancer cells.
authors.affiliation: Gray Institute for Radiation Oncology & Biology, University of Oxford, Oxford, UK.
authors.forename: Tine S
authors.initials: TS
authors.lastname: Mantoni
authors.forename: Roy R E
authors.initials: RR
authors.lastname: Schendel
authors.forename: Franz
authors.initials: F
authors.lastname: Rödel
authors.forename: Gerald
authors.initials: G
authors.lastname: Niedobitek
authors.forename: Osama
authors.initials: O
authors.lastname: Al-Assar
authors.forename: Atsuhi
authors.initials: A
authors.lastname: Masamune
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Brunner
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000378:metabolism* / Q000532:radiotherapy*; D001706:Biopsy; D018920:Coculture Techniques; D015331:Cohort Studies; D018450:Disease Progression; D020869:Gene Expression Profiling; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D016130:Immunophenotyping; D015676:Osteonectin / Q000096:biosynthesis*; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000378:metabolism* / Q000532:radiotherapy*; D011379:Prognosis; D051057:Proto-Oncogene Proteins c-akt / Q000378:metabolism; D013997:Time Factors; D053773:Transforming Growth Factor beta1 / Q000378:metabolism
chemical_list: D015676:Osteonectin; D053773:Transforming Growth Factor beta1; D051057:Proto-Oncogene Proteins c-akt