title: Systematic review of immunohistochemical biomarkers to identify prognostic subgroups of patients with pancreatic cancer.
abstract: BACKGROUND
  Pancreatic ductal adenocarcinoma (PDAC) carries a dismal prognosis. There is a need to identify prognostic subtypes of PDAC to predict clinical and therapeutic outcomes accurately, and define novel therapeutic targets. The purpose of this review was to provide a systematic summary and review of available data on immunohistochemical (IHC) prognostic and predictive markers in patients with PDAC.
  
  
  METHODS
  Relevant articles in English published between January 1990 and June 2010 were obtained from PubMed searches. Other articles identified from cross-checking references and additional sources were reviewed. The inclusion was limited to studies evaluating IHC markers in a multivariable setting.
  
  
  RESULTS
  Database searches identified 76 independent prognostic and predictive molecular markers implicated in pancreatic tumour growth, apoptosis, angiogenesis, invasion and resistance to chemotherapy. Of these, 11 markers (Ki-67, p27, p53, transforming growth factor β1, Bcl-2, survivin, vascular endothelial growth factor, cyclo-oxygenase 2, CD34, S100A4 and human equilibrative nucleoside transporter 1) provided independent prognostic or predictive information in two or more separate studies.
  
  
  CONCLUSIONS
  None of the molecular markers described can be recommended for routine clinical use as they were identified in small cohorts and there were inconsistencies between studies. Their prognostic and predictive values need to be validated further in prospective multicentre studies in larger patient populations. A panel of molecular markers may become useful in predicting individual patient outcome and directing novel types of intervention.
authors.affiliation: Department of Surgery, Lund University and Skåne University Hospital Lund, Lund, Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Ansari
authors.forename: A
authors.initials: A
authors.lastname: Rosendahl
authors.forename: J
authors.initials: J
authors.lastname: Elebro
authors.forename: R
authors.initials: R
authors.lastname: Andersson
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor