Clinical Research About Relationship Between The Prognosis Of Pancreatic Carcinoma And Expression Of Psca And VEGF

BackgroundPancreatic cancer (PC) is one of normal malignant digestive system tumor whichearly diagnosis is still difficult. The majority of patients are diagnosed to be in advancedperiod．Because of the high malignant degree and unresectable rate,the prognosis is verypoor.In recent years,with many progresses of the foundational and clinical researchhaving been made,the diagnosis and treatment have acquire a great development.Butthere are still short of specific tumor marker and uniform treatment approach.PURPOSETo study the factors influencing early diagnosis, survival time and prognosis inpatients with pancreatic carcinoma．To investigate the expression of PSCA, VEGF in human pancreatic carcinomaand to explore its relationship to differentiation degree，the size，invasion and metastasisof human pancreatic carcinoma．METHODSThe clinical data of156patients who had complete follow—up data withpancreatic carcinoma treated from January2005to December2010were reviewedrespectively.Survival rate was calculated by the life table method and theKaplan—Meier estimation．Log-rank test was used for univariate prognostic analysisand Cox regression was used for multivariate prognostic analysis.The expression of PSCA, VEGF in62pancreatic carcinoma samples and in20adjacent normal pancreatic tissues were detected by using immunohistochemical SPmethod． RESULTSIn this study, The peak age of the patients was60—70years old and77.50％of the patients were more than45years old, The average median age was64years old；the major clinical manifestation were abdominal pain, abdominal distention andjaundice． B-ultrasound and CT were the major imaging tests. The positive rate were60.63％in B-ultrasound and87.39％in CT respectively．The sensitivity ofCAl9-9was84.62％．Lymph nodes, celiac large blood vessels and the liver were maintransfer parts for pancreatic cancer.In this study,lymph node metastasis had a total of69patients, while vascular invasion involving70cases and liver metastasis affecting55cases. The median survival time was4.0months．Overall survival rates at1—5yearsurvival rates were25.00%、14.00%、6.00%、4.00%、0．Univariate analysis suggestedthat age>60years old， CAl9-9>100u/ml， TNM Ⅲ or Ⅳ stage， non—surgicaltreatment,large size tumor and Liver metastasis were poor prognostic factors；Cox-multivariate analysis showed that TNM stage， ascites were independent riskfactors for dismal prognosis．The results showed that the positive and negative expression of PSCA in62pancreatic carcinoma tissues were43cases(69.4％) and19cases(30.6％); thepositive and negative expression of VEGF in62pancreatic carcinoma tissues were47cases(75.8％) and15cases(24.2％); the positive and negative expression of PSCAin20adjacent normal pancreas tissues were11cases(55％) and9cases(45％); thepositive and negative expression of VEGF in20adjacent normal pancreas tissues were13cases(65％)and7cases(35％). The expression of PSCA、VEGF in pancreatic cancertissues were significantly higher than in the adjacent normal pancreas tissues and alsohigher in pantients with lymph nodes,vascular invasion and metastses than without.Thelevel of PSCA、VEGF were markedly correlated to the tumor differentiation, stages andsurvival time but had no relationship with the tumor size.CONCLUSIONSAscites， tumor stage， treatment approach affected the prognosis of patients with pancreatic cancer．Early diagnosis and treatment were important to improve the survivaltime and prognosis of patients with pancreatic cancer．The detection of expression of PSCA, VEGF is helpful in the diagnosis ofpancreatic carcinoma，and it might be also regards as an important parameter fordetermining tumor malignant degree and prognosis．...