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10.1245/s10434-007-9669-0
Annals of Surgical Oncology 15:609-617 (2008)
© 2008 Society of Surgical Oncology
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Original Article

Prognostic Significance of the Immediate Early Response Gene X-1 (IEX-1) Expression in Pancreatic Cancer

Tetsuro Sasada, MD, PhD1, Koichi Azuma, MD, PhD2, Tatsuya Hirai3, Hiroki Hashida, MD, PhD1, Michiyuki Kanai, MD, PhD1, Takashi Yanagawa, PhD4 and Arimichi Takabayashi, MD, PhD1

1 Department of Surgery, Kitano Hospital, Tazuke-Kofukai Medical Research Institute, Osaka, Japan
2 Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
3 Department of Pathology, Kitano Hospital, Tazuke-Kofukai Medical Research Institute, Osaka, Japan
4 Biostatistics Center, Kurume University, Kurume, Japan

Correspondence: Address correspondence and reprint requests to: Tetsuro Sasada, MD, PhD; E-mail: tsasada{at}kitano-hp.or.jp

Background: The immediate early response gene X-1 (IEX-1) is a stress-inducible protein that is involved in the regulation of cell proliferation and apoptosis. The aim of this study was to evaluate the prognostic significance of IEX-1 expression in pancreatic cancer.

Methods: IEX-1 protein expression was examined on paraffin-embedded specimens from 78 patients with pancreatic ductal adenocarcinoma using immunohistochemistry. The relationships between the IEX-1 expression and other clinicopathological parameters and patient survival were evaluated. A similar analysis was conducted in a subgroup of 48 patients, who underwent a macroscopically curative resection with detailed information on the pathological findings.

Results: Among 78 pancreatic cancer patients, 41 patients (53%) were positive for IEX-1 staining. In a multivariate analysis, curative operation (P < .001), pathological stage I–III (P = .001), and positive IEX-1 expression (P = .002) were significantly favorable factors for survival. In a subgroup of 48 patients undergoing a macroscopically curative surgery, IEX-1 expression was positive in 28 patients (58%). A significant negative correlation was observed between the IEX-1 expression and serosal (P = .032) or arterial (P = .040) invasion of tumors. A multivariate analysis demonstrated limited local invasion (pT1-3, P = .021), negative lymph node involvement (pN0, P < .001), and positive IEX-1 expression (P = .004) to be significantly favorable factors for survival.

Conclusions: The positive IEX-1 expression in tumor tissues may be associated with a better prognosis in pancreatic cancer. An immunohistochemical assessment of IEX-1 expression may therefore be helpful for predicting patient prognosis in this disease.

Key Words: IEX-1 • Pancreatic cancer • Prognosis • Immunohistochemistry






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