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Advanced pancreatic cancer- how to choose an adequate treatment option

World Journal of Gastroenterology 2015年第38期21卷 10709-10713页

作者： eija A korkeila Department of Oncology Turku University Hospital and University of Turku

The prognosis of pancreatic adenocarcinoma is poor,making it one of the leading causes of cancerrelated death. The 5-year overall survival rate remains below 5% and little progress is made during the past decade. Only about 10%-20% of patients are eligible for curative-intent surgery and the majority end up having recurring disease even after radical surgery and postoperative adjuvant chemotherapy. Chemotherapy in metastatic disease is palliative at best,aiming at disease and symptom control and prolongation of life. Treatment always causes side effects,the degree of which varies from patient to patient,depending on the patient's general condition,concomitant morbidities as well as on the chosen treatment modality. Why is pancreatic cancer so resistant to treatment? How to best help the patient to reach the set treatment goals?

关键词： Pancreatic cancer Chemotherapy Palliative treatmen

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Up-regulation of α-catenin is associated with increased lymph node involvement in colorectal cancer

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World Journal of Gastroenterology 2008年第31期14卷 4903-4908页

作者： Adam Elzagheid Abdelbaset Buhmeida eija korkeila Yrj Collan Kari Syrjnen Seppo Pyrhnen Department of Pathology University of Turku Kiinamyllynkatu 10 Turku FIN-20520 Finland Department of Pathology Faculty of Medicine Al-Arab Medical University Benghazi Libya Department of Oncology and Radiotherapy Turku University Hospital Savitehtaankatu 1 PB 52 Turku FIN-20521 Finland Department of Pathology University of Turku Kiinamyllynkatu 10 Turku FIN-20520 Finland

AIM: To investigate the changing pattern of α-catenin expression and its relationship to clinical and pathological features of colorectal cancer (CRC) patients. METHODS: Archival tumor samples were analyzed using immunohistochemistry (IHC) for α-catenin in 91 patients with advanced CRC. RESULTS: The values of α-catenin membrane index (MI) and cytoplasmic index (CI) were significantly related to the depth of tumor invasion (P = 0.027, P = 0.020, respectively), high indices being associated with increased depth of the primary tumor invasion (T3 and T4). Similarly, patients with high α-catenin expression had a signifi cantly increased risk of lymph node metastasis (32/39 vs 37/52 for MI and 37/45 vs 32/46 for CI) (P = 0.001, P = 0.0001, respectively, for LNN status). An altered expression (i.e., cytoplasmic pattern) was also related (P = 0.047) to the response to chemotherapy; patients with low CI were more responsive (CR: 7/46) than patients with high CI values (CR: 0/45). There was a marginal effect on survival in patients time with metastases (SWM) (P = 0.087); patients with low CI showing slightly longerSWM, but no such effect on disease free survival (DFS) or disease specifi c survival (DSS). As to co-expression with another member of the adhesion complex (β-catenin), high α-catenin/β-catenin MI index was of marginal signifi cance in predicting longer DSS (P = 0.063, log-rank). CONCLUSION: The results implicate that high α-catenin expression is intimately involved in the key regulatory mechanisms leading to invasive phenotype, lymph node metastases, and progressive disease in CRC.

关键词： Colorectal carcinoma Alpha-catenin Membrane staining Cytoplasmic staining Prognosis

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Nuclear β-catenin expression as a prognostic factor in advanced colorectal carcinoma

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World Journal of Gastroenterology 2008年第24期14卷 3866-3871页

作者： Adam Elzagheid Abdelbaset Buhmeida eija korkeila Yrj Collan Kari Syrjnen Seppo Pyrhnen Department of Pathology Faculty of Medicine Al-Arab Medical University Department of Oncology and Radiotherapy Turku University Hospital Department of pathology University of Turku

AIM： To investigate the changing pattern of β-catenin expression and its prognostic value in advanced colorectal cancer （CRC）. METHODS： Archival tumor samples were analyzed for β-catenin using immunohistochemistry （IHC） in 95 patients with advanced CRC. RESULTS： Membranous β-catenin expression was found in the normal colorectal epithelium. Almost 100% of CRC cases showed membranous and cytoplasmic expression, and 55 （58%） cases showed nuclear expression. In univariate （Kaplan-Meier） survival analysis, only the nuclear index （NI） was a significant predictor of disease free survival （DFS）（P = 0.023; n = 35）, with a NI above the median associated with longer DFS （34.2 too） than those with a NI below the median （15.5 too）（P = 0.045, ANOVA）. The other indices were not significant predictors of DFS, and none of the three tested indices （for membranous, cytoplasmic, or nuclear expression） predicted diseasespecific survival （DSS）. However, when dichotomized as positive or negative nuclear expression, the former was a significant predictor of more favorable DFS （P = 0.041） and DSS （P = 0.046）. CONCLUSION： Nuclear β-catenin expression provides additional information in predicting patient outcome in advanced CRC.

关键词： Colorectal carcinoma β-catenin membranestaining Cytoplasmic staining, Nuclear staining Immunohistochemistry Prognosis Disease-freesurvival Disease-specific survival

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Lack of CD44 variant 6 expression in rectal cancer invasive front associates with early recurrence

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World Journal of Gastroenterology 2012年第33期18卷 4549-4556页

作者： Suvi Tuulia Avoranta eija Annika korkeila Kari Juhani Syrjnen Seppo Olavi Pyrhnen Jari Toivo Tapio Sundstrm Department of Oncology and Radiotherapy University of Turku and Turku University Hospital FIN-20521 Turku Finland Department of Pathology University of Turku and Turku University Hospital FIN-20520 Turku Finland

AIM: To investigate the prognostic value of CD44 variant 6 (CD44v6), a membranous adhesion molecule, in rectal cancer. METHODS: Altogether, 210 rectal cancer samples from 214 patients treated with short-course radiotherapy (RT, n = 90), long-course (chemo) RT (n = 53) or surgery alone (n = 71) were studied with immunohistochemistry for CD44v6. The extent and intensity of membranous and cytoplasmic CD44v6 staining, and the intratumoral membranous staining pattern, were ***: Membranous CD44v6 expression was seen in 84% and cytoplasmic expression in 81% of the cases. In 59% of the tumors with membranous CD44v6 expression, the staining pattern in the invasive front was determined as "front-positive" and in 41% as "front-negative". The latter pattern was associated with narrower circumferential margin (P = 0.01), infiltrative growth pattern (P < 0.001), and shorter disease-free survival in univariate survival analysis (P = 0.022) when compared to the "front-positive" tumors. CONCLUSION: The lack of membranous CD44v6 in the rectal cancer invasive front could be used as a method to identify patients at increased risk for recurrent disease.

关键词： CD44 variant 6 Rectal cancer Invasive front Disease-free survival Disease-specific survival

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