title: The role of SPARC expression in pancreatic cancer progression and patient survival.
abstract: BACKGROUND
  Secreted protein acidic and rich in cysteine (SPARC) is a matricellular glycoprotein that has been implicated in tumor-stroma interactions in pancreatic cancer. Here we evaluated the expression of SPARC during the progression of pancreatic cancer and its correlation with survival following curative intent surgery.
  
  
  METHODS
  The expression profile of SPARC was investigated in normal pancreas, invasive adenocarcinoma, and lymph node metastasis by immunohistochemistry. Kaplan-Meier and multivariate Cox regression were used to assess for mortality risk.
  
  
  RESULTS
  None (0%) of 10 normal pancreata, 68 (77%) of 88 primary tumors, and 28 (67%) of 42 lymph node metastases were labeled with the SPARC antibody used in this study. SPARC was expressed exclusively in stromal cells. The survival of patients with high stromal SPARC expression was significantly worse than that of the patients with low stromal SPARC expression (11.5 vs 25.3 months; p = 0.020). Multivariate analysis showed that stromal SPARC expression (hazard ratio (HR) 2.12; p = 0.012), tumor location (body/tail) (HR 2.95; p = 0.003), and adjuvant chemotherapy (HR 0.55; p = 0.018) were significant independent risk factors.
  
  
  CONCLUSIONS
  This study describes the pattern of SPARC expression in pancreatic neoplastic progression and supports the role of stromal SPARC expression as a prognostic factor and target for directed therapy.
authors.affiliation: Department of Surgery, Clinical Sciences Lund, Skåne University Hospital, Lund University , Lund , Sweden.
authors.forename: Chinmay
authors.initials: C
authors.lastname: Gundewar
authors.forename: Agata
authors.initials: A
authors.lastname: Sasor
authors.forename: Katarzyna Said
authors.initials: KS
authors.lastname: Hilmersson
authors.forename: Roland
authors.initials: R
authors.lastname: Andersson
authors.forename: Daniel
authors.initials: D
authors.lastname: Ansari
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D017024:Chemotherapy, Adjuvant / Q000379:methods; D018450:Disease Progression; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015676:Osteonectin / Q000378:metabolism*; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D015676:Osteonectin
keywords: SPARC; metastasis; normal pancreas; pancreatic cancer; prognosis; stroma