title: Low expression of junctional adhesion molecule A is associated with metastasis and poor survival in pancreatic cancer.
abstract: BACKGROUND
  Characterized by its highly aggressive tumor biology, pancreatic cancer still remains a fatal diagnosis. The junctional adhesion molecule A (JAM-A) is a type I transmembrane glycoprotein, which recently has been shown to affect the prognosis of several human malignancies.
  
  
  METHODS
  JAM-A antigen expression was investigated retrospectively by immunohistochemistry in paraffin-embedded primary tumor tissue samples from a series (n = 186) of consecutive patients with pancreatic adenocarcinoma. Survival was calculated by Kaplan-Meier curves. Parameters found to be of prognostic significance in univariate analysis were verified in a multivariate Cox regression model.
  
  
  RESULTS
  Low expression of JAM-A was observed in 79 (42 %) of 186 pancreatic cancer specimens and was significantly associated with poor overall survival (P < 0.01). By univariate analysis, low expression of JAM-A was found to correlate with positive lymph node status (P = 0.02), the presence of distant metastasis (P = 0.05), and tumor grade (P = 0.04), suggesting it may be an important event involved in cancer progression. Furthermore, in the subgroup of patients with surgically resected pancreatic cancer, low expression of JAM-A significantly correlated with decreased progression-free survival (P < 0.01). Multivariate analysis revealed JAM-A to be an independent predictor of poor outcome.
  
  
  CONCLUSIONS
  These findings suggest for the first time that low levels of JAM-A expression in pancreatic cancer are associated with poor clinical outcome. JAM-A may represents a target molecule for functional inactivation and serve as a novel biomarker of adverse prognosis in pancreatic cancer.
authors.affiliation: Division of Hematology & Oncology, Medical University Innsbruck, Innsbruck, Austria. dominic.fong@i-med.ac.at
authors.forename: Dominic
authors.initials: D
authors.lastname: Fong
authors.forename: Gilbert
authors.initials: G
authors.lastname: Spizzo
authors.forename: Manfred
authors.initials: M
authors.lastname: Mitterer
authors.forename: Andreas
authors.initials: A
authors.lastname: Seeber
authors.forename: Michael
authors.initials: M
authors.lastname: Steurer
authors.forename: Guenther
authors.initials: G
authors.lastname: Gastl
authors.forename: Ines
authors.initials: I
authors.lastname: Brosch
authors.forename: Patrizia
authors.initials: P
authors.lastname: Moser
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000401:mortality* / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000378:metabolism / Q000401:mortality* / Q000556:secondary; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000378:metabolism*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D015815:Cell Adhesion Molecules; C407243:F11R protein, human; D011956:Receptors, Cell Surface