title: CD74 is a novel prognostic factor for patients with pancreatic cancer receiving multimodal therapy.
abstract: BACKGROUND
  Pancreatic ductal adenocarcinoma (PDAC) is still one of the most fatal cancers, although its prognosis has improved recently with the introduction of multimodal therapy. To further develop effective treatment for PDAC, establishment of prognostic indicators for patients receiving multimodal therapy is essential.
  
  
  METHODS
  Sixty-eight patients receiving curative extended resection combined with preoperative chemoradiation and postoperative chemotherapy for primary PDAC were selected. Immunohistochemistry using anti-CD74 antibody on paraffin-embedded tissue samples was performed, and cases were divided into two groups according to the ratio of CD74-positive cells: expression level I, CD74-positive cells <70%; level II, CD74-positive cells >or=70%. The correlation of CD74 expression level with clinicopathological features and overall survival was evaluated.
  
  
  RESULTS
  Forty-seven (69.1%) and 21 (30.9%) patients showed level I and II CD74 expression, respectively. Patients with level II CD74 expression showed a higher rate of lymphatic permeation (P = 0.04) and perineural invasion (P = 0.01) compared with those with level I expression. Patients with level I CD74 expression had a significantly better survival rate than those with level II (P = 0.003). Among the patients with pathological tumor-node-metastasis stages I and II, those with level I CD74 expression showed a significantly better prognosis than those with level II (P = 0.006). Multivariate analysis revealed CD74 expression level and vascular permeation of carcinoma as independent prognostic indicators.
  
  
  CONCLUSIONS
  CD74 expression proved as a useful prognostic indicator for PDAC treated with multimodal therapy.
authors.affiliation: Departments of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Nagata
authors.forename: Yu-Fen
authors.initials: YF
authors.lastname: Jin
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yoshizato
authors.forename: Miki
authors.initials: M
authors.lastname: Tomoeda
authors.forename: Misa
authors.initials: M
authors.lastname: Song
authors.forename: Norishige
authors.initials: N
authors.lastname: Iizuka
authors.forename: Masanori
authors.initials: M
authors.lastname: Kitamura
authors.forename: Hidenori
authors.initials: H
authors.lastname: Takahashi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ohigashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishikawa
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tomita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000944:Antigens, Differentiation, B-Lymphocyte / Q000378:metabolism*; D021441:Carcinoma, Pancreatic Ductal / Q000378:metabolism* / Q000556:secondary / Q000628:therapy*; D005260:Female; D000949:Histocompatibility Antigens Class II / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000944:Antigens, Differentiation, B-Lymphocyte; D000949:Histocompatibility Antigens Class II; C045084:invariant chain