title: Human Equilibrative Nucleoside Transporter 1 Expression in Endoscopic Ultrasonography-Guided Fine-Needle Aspiration Biopsy Samples Is a Strong Predictor of Clinical Response and Survival in the Patients With Pancreatic Ductal Adenocarcinoma Undergoing Gemcitabine-Based Chemoradiotherapy.
abstract: OBJECTIVE
  This study aimed to clarify whether pretreatment human equilibrative nucleoside transporter (hENT1) expressions in endoscopic ultrasonography-guided fine-needle aspiration biopsy (EUS-FNAB) specimens obtained from resectable, borderline resectable, and locally advanced unresectable pancreatic ductal adenocarcinoma (PDAC) are concordant with those in the resected specimen after gemcitabine-based chemoradiotherapy (Gem-CRT) and to validate the utility of hENT1 expression using EUS-FNAB samples as a prognostic marker.
  
  
  METHODS
  We evaluated the relationship between hENT1 expressions assessed by immunohistochemical staining and clinical outcomes in 51 of 76 patients with PDAC who were diagnosed by EUS-FNAB and received preoperative Gem-CRT.
  
  
  RESULTS
  The concordance rate of hENT1 expressions was 89.2% (K = 0.681). Median survival time (month) in the 51 whole patients and 37 patients with resection was significantly longer in hENT1 positive than in hENT1 negative: 25.0 and 30.0 versus 9.0 and 9.0, respectively. A multivariate analysis confirmed that hENT1 expression was an independent prognostic factor in both whole patients and those with resection. Regardless of T3 and T4, hENT1-positive patients with resection had significantly better prognosis than hENT1-negative patients, whose prognosis was similar to those without resection.
  
  
  CONCLUSIONS
  The assessment of hENT1 expression using EUS-FNAB samples before Gem-CRT provides important information on patients with PDAC who can benefit from curative-intent resection.
authors.affiliation: From the *Gastroenterology and Hepatology, †Hepatobiliary Pancreatic and Transplant Surgery, and ‡Oncologic Pathology, Mie University Graduate School of Medicine; §Faculty of Health Science, Suzuka University of Medical Science; Departments of ∥Pathology, ¶Radiology, and #Endoscopy, Mie University Graduate School of Medicine; **Clinical Research Support Center, Mie University Graduate Hospital; and ††Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Yamada
authors.forename: Shugo
authors.initials: S
authors.lastname: Mizuno
authors.forename: Katsunori
authors.initials: K
authors.lastname: Uchida
authors.forename: Misao
authors.initials: M
authors.lastname: Yoneda
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kanayama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Inoue
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Murata
authors.forename: Naohisa
authors.initials: N
authors.lastname: Kuriyama
authors.forename: Masashi
authors.initials: M
authors.lastname: Kishiwada
authors.forename: Masanobu
authors.initials: M
authors.lastname: Usui
authors.forename: Noriko
authors.initials: N
authors.lastname: Ii
authors.forename: Junya
authors.initials: J
authors.lastname: Tsuboi
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tano
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hamada
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Tanaka
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Horiki
authors.forename: Toru
authors.initials: T
authors.lastname: Ogura
authors.forename: Taizo
authors.initials: T
authors.lastname: Shiraishi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Katayama
authors.forename: Shuji
authors.initials: S
authors.lastname: Isaji
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000096:biosynthesis; D021441:Carcinoma, Pancreatic Ductal / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D033721:Equilibrative Nucleoside Transporter 1 / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010179:Pancreas / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use; D000093542:Gemcitabine
chemical_list: D014408:Biomarkers, Tumor; D033721:Equilibrative Nucleoside Transporter 1; D011838:Radiation-Sensitizing Agents; D003841:Deoxycytidine; D000093542:Gemcitabine