title: Tumour basement membrane laminin expression predicts outcome following curative resection of pancreatic head cancer.
abstract: BACKGROUND
  Although widely fragmented BMs have been associated with adverse outcome in several cancer types, comparatively little is known with respect to its effect on the prognosis of pancreatic cancer. The aim of the current study was therefore to determine the prognostic value of tumour basement membrane (BM) continuity in two anatomically closely related, however, prognostically different tumours, pancreatic head- and periampullary cancer.
  
  
  METHODS
  Tumour BM continuity was determined by immunohistochemical staining of its two major components, laminin and collagen type IV. Associations were made with recurrence free survival (RFS), cancer-specific survival (CSS), overall survival (OS) and conventional prognostic factors.
  
  
  RESULTS
  Fifty-nine and 61% of pancreatic head and periampullary tumours, respectively, showed limited BM laminin expression. Whereas 43% and 41% of pancreatic head and periampullary cancers, respectively, showed limited BM collagen type IV expression. Limited BM laminin was associated with poor outcome following curative resection of pancreatic head cancer (P=0.034, 0.013 and 0.017 for RFS, CSS and OS, respectively). Two and a half times as many patients with ≥ 25% BM laminin were recurrence free and alive 5 years following resection compared with those with limited BM laminin. Although staining patterns of both BM components were weakly correlated with each other, BM collagen type IV expression was not significantly associated with outcome in either tumour type.
  
  
  CONCLUSIONS
  Discontinuous BMs, determined by laminin expression, are associated with poor outcome following curative resection of pancreatic head cancer.
authors.affiliation: Department of Surgery, Laboratory of Experimental Surgical Oncology, Section Surgical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands. j.a.vanderzee@erasmusmc.nl
authors.forename: J A
authors.initials: JA
authors.lastname: van der Zee
authors.forename: C H J
authors.initials: CH
authors.lastname: van Eijck
authors.forename: W C J
authors.initials: WC
authors.lastname: Hop
authors.forename: K
authors.initials: K
authors.lastname: Biermann
authors.forename: B M
authors.initials: BM
authors.lastname: Dicheva
authors.forename: A Lb
authors.initials: AL
authors.lastname: Seynhaeve
authors.forename: G A
authors.initials: GA
authors.lastname: Koning
authors.forename: A M M
authors.initials: AM
authors.lastname: Eggermont
authors.forename: T L M
authors.initials: TL
authors.lastname: Ten Hagen
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000378:metabolism* / Q000473:pathology*; D021441:Carcinoma, Pancreatic Ductal / Q000378:metabolism* / Q000473:pathology*; D024141:Collagen Type IV / Q000378:metabolism; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007797:Laminin / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000378:metabolism* / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies
chemical_list: D024141:Collagen Type IV; D007797:Laminin