title: High levels of nucleolar expression of nucleolin are associated with better prognosis in patients with stage II pancreatic ductal adenocarcinoma.
abstract: OBJECTIVE
  Nucleolin is a major nucleolar protein that has been shown to be overexpressed in rapidly dividing cells and plays an essential role in cell proliferation and survival. However, the expression and significance of nucleolin in pancreatic ductal adenocarcinoma (PDA) have not been studied.
  
  
  METHODS
  We used a tissue microarray consisting of 1.0-mm cores of tumor and paired nonneoplastic pancreatic tissue from 69 pancreaticoduodenectomy specimens with stage II PDA. Nucleolin expression was evaluated by immunohistochemistry and scored quantitatively by image analysis. Nucleolin expression was classified as nucleolin-high or nucleolin-low using the median nucleolin labeling index of 3.5% as cutoff. Staining results were correlated with clinicopathologic features and survival.
  
  
  RESULTS
  Both PDAs and PDA cell lines showed nucleolar staining for nucleolin. Nucleolin expression was higher in PDAs and PDA cell lines than in nonneoplastic ductal epithelial cells. Among the 69 stage II PDAs, 34 (49%) were nucleolin-high. The median overall survival was 65.2 +/- 16.3 months for patients who had nucleolin-high PDAs compared with 19.5 +/- 3.3 months for patients whose tumors were nucleolin-low (P = 0.03, log-rank method). No significant correlation between nucleolin expression and other clinicopathologic parameters was found. In multivariate analysis, nucleolin expression was a prognostic factor for overall survival in patients with stage II PDA independent of patient's age, gender, tumor size, differentiation, and lymph node status.
  
  
  CONCLUSIONS
  Nucleolin was overexpressed in PDAs and PDA cell lines. A high level of nucleolar expression of nucleolin was an independent prognostic marker for better survival for patients with stage II PDAs.
authors.affiliation: Department of Pathology, The University of Texas M D Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Lan
authors.initials: L
authors.lastname: Peng
authors.forename: John
authors.initials: J
authors.lastname: Liang
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.forename: Xianzhou
authors.initials: X
authors.lastname: Song
authors.forename: Asif
authors.initials: A
authors.lastname: Rashid
authors.forename: Henry F
authors.initials: HF
authors.lastname: Gomez
authors.forename: Lynda J
authors.initials: LJ
authors.lastname: Corley
authors.forename: James L
authors.initials: JL
authors.lastname: Abbruzzese
authors.forename: Jason B
authors.initials: JB
authors.lastname: Fleming
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Evans
authors.forename: Huamin
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015153:Blotting, Western; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy; D002466:Cell Nucleolus / Q000378:metabolism*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy; D010750:Phosphoproteins / Q000096:biosynthesis*; D011379:Prognosis; D016601:RNA-Binding Proteins / Q000096:biosynthesis*; D012189:Retrospective Studies; D046888:Tissue Array Analysis; D014407:Tumor Cells, Cultured; D000097796:Nucleolin
chemical_list: D010750:Phosphoproteins; D016601:RNA-Binding Proteins; D000097796:Nucleolin