Decoy receptor 3 (DcR3) overexpression predicts the prognosis and pN2 in pancreatic head carcinoma
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WORLD JOURNAL OF SURGICAL ONCOLOGY
RESEARCH
Open Access
Decoy receptor 3 (DcR3) overexpression predicts the prognosis and pN2 in pancreatic head carcinoma Jian Zhou1†, Shiduo Song1†, Dechun Li1†, Songbing He1, Bing Zhang2, Zhenxin Wang3 and Xinguo Zhu1*
Abstract Background: This study was carried out to examine decoy receptor 3 (DcR3) expression and investigate its clinical and prognostic significance in patients with pancreatic head carcinoma. Methods: Tissue samples were obtained from 50 patients with pancreatic head carcinoma. DcR3 protein expression in tissues and sera was assessed by immunohistochemistry and ELISA. Correlations between DcR3 and clinicopathologic features and prognoses were analyzed statistically. Results: Serum DcR3 levels were significantly elevated in patients with pancreatic head carcinoma compared with patients with cystadenoma and healthy individuals (P < 0.01 and P < 0.01, respectively). DcR3 overexpression correlated with lymph node metastases and TNM stages (P < 0.05 and P < 0.05, respectively). Median overall survival for the high DcR3 group was 16.3 months, compared to 21.6 months for the low DcR3 group (P < 0.05). In the low DcR3 group, no significant difference was found in the overall survival between patients who underwent standard pancreatoduodenectomy (SPD) and those who had radical pancreatoduodenectomy (RPD) (P > 0.05). In the high DcR3 group, the median overall survival rates were 16.8 months in the RPD group and 13.5 months in the SPD group (P < 0.05). Conclusions: We found that DcR3 was overexpressed in pancreatic head carcinoma. The patients with high DcR3 levels had higher pN2 stages than those with low DcR3 levels. Detecting serum DcR3 level preoperatively might be an additional approach for evaluating pN2 stage and guiding the range of lymphadenectomy. Keywords: DcR3, Lymphadenectomy, Pancreatic head carcinoma, Prognosis
Background Pancreatic carcinoma is one of the most lethal and aggressive of all malignancies. It is the fourth leading cause of cancer-related deaths in the Western world and leads to an estimated 277,000 deaths per year worldwide [1]. The median overall survival of patients with pancreatic carcinoma is less than 6 months, and the 5-year survival rate is dismal at 2% to 6% [2]. Despite advances in chemotherapy and radiotherapy over the past few decades, the overall prognosis for patients with pancreatic carcinoma has remained essentially unchanged [3]. Surgical resection is the only curative therapy if the tumor
* Correspondence: [email protected] † Equal contributors 1 Department of General Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China Full list of author information is available at the end of the article
is limited and without vascular encasement or distant metastases. About 65% of pancreatic carcinomas are in the head of the gland, approximately 25% are in the body and tail and the remainder are multifocal. Pancreatoduodenectomy (PD) is considered the operation of choice for pancrea
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