Maximum Standard Uptake Value as a Clinical Biomarker for Detecting Loss of SMAD4 Expression and Early Systemic Tumor Recurrence in Resected Left-Sided Pancreatic Cancer

ChangMoo Kang, Ho Kyoung Hwang, Jiae Park, Changsoo Kim, Seong Kyoung Cho, Mijin Yun, Woo Jung Lee

Research output: Contribution to journalArticle

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Abstract

This study investigated the oncologic impact of loss of SMAD4 expression in resected left-sided pancreatic cancer and its correlation with tumor metabolism. From 2005 to 2011, the medical records of patients who underwent radical distal pancreatectomy for resectable pancreatic cancer were retrospectively reviewed. Formalin-fixed, paraffin embedded tissue from 32 patients was investigated. Clinicopathological characteristics, immunostaining of SMAD4, and positron emission tomography-based parameters were analyzed in relation to oncologic outcomes. Thirteen patients were women and 19 were men, with a mean age of 63 ± 9.4 years. Mean resected tumor size was 3.3 ± 1.5 cm. Ten patients (31.3%) showed loss of SMAD4 expression. No significant clinicopathological differences were noted according to SMAD4 expression (P > 0.05); however, patients with loss of SMAD4 showed significantly poorer disease-free survival (mean 57.4 months vs mean 17.6 months, P = 0.006). As a cut-off value, a SUV max of 4.5 was found to be predictive of loss of SMAD4 with a sensitivity of 75% and a specificity of 84.6%. In logistic regression analysis, SUV max >4.5 was found to infer a 16-fold higher risk for loss of SMAD4 in resected left-sided pancreatic cancers (Exp[β] = 16.5, P = 0.012, 95% confidence interval: 1.832-148.606). Loss of SMAD4 is associated with poor oncologic outcomes. SUV max can predict loss of SMAD4 in resected left-sided pancreatic cancer. SUV max may be a clinical biomarker for detecting loss of SMAD4 expression and predicting early systemic metastasis.

Original languageEnglish
Article numbere3452
JournalMedicine (United States)
Volume95
Issue number17
DOIs
Publication statusPublished - 2016 Apr 1

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Pancreatic Neoplasms
Biomarkers
Recurrence
Neoplasms
Pancreatectomy
Positron-Emission Tomography
Paraffin
Formaldehyde
Disease-Free Survival
Medical Records
Logistic Models
Regression Analysis
Confidence Intervals
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{f836efe522ca4be4ab30ec1c81e7ceee,
title = "Maximum Standard Uptake Value as a Clinical Biomarker for Detecting Loss of SMAD4 Expression and Early Systemic Tumor Recurrence in Resected Left-Sided Pancreatic Cancer",
abstract = "This study investigated the oncologic impact of loss of SMAD4 expression in resected left-sided pancreatic cancer and its correlation with tumor metabolism. From 2005 to 2011, the medical records of patients who underwent radical distal pancreatectomy for resectable pancreatic cancer were retrospectively reviewed. Formalin-fixed, paraffin embedded tissue from 32 patients was investigated. Clinicopathological characteristics, immunostaining of SMAD4, and positron emission tomography-based parameters were analyzed in relation to oncologic outcomes. Thirteen patients were women and 19 were men, with a mean age of 63 ± 9.4 years. Mean resected tumor size was 3.3 ± 1.5 cm. Ten patients (31.3{\%}) showed loss of SMAD4 expression. No significant clinicopathological differences were noted according to SMAD4 expression (P > 0.05); however, patients with loss of SMAD4 showed significantly poorer disease-free survival (mean 57.4 months vs mean 17.6 months, P = 0.006). As a cut-off value, a SUV max of 4.5 was found to be predictive of loss of SMAD4 with a sensitivity of 75{\%} and a specificity of 84.6{\%}. In logistic regression analysis, SUV max >4.5 was found to infer a 16-fold higher risk for loss of SMAD4 in resected left-sided pancreatic cancers (Exp[β] = 16.5, P = 0.012, 95{\%} confidence interval: 1.832-148.606). Loss of SMAD4 is associated with poor oncologic outcomes. SUV max can predict loss of SMAD4 in resected left-sided pancreatic cancer. SUV max may be a clinical biomarker for detecting loss of SMAD4 expression and predicting early systemic metastasis.",
author = "ChangMoo Kang and Hwang, {Ho Kyoung} and Jiae Park and Changsoo Kim and Cho, {Seong Kyoung} and Mijin Yun and Lee, {Woo Jung}",
year = "2016",
month = "4",
day = "1",
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language = "English",
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journal = "Medicine (United States)",
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Maximum Standard Uptake Value as a Clinical Biomarker for Detecting Loss of SMAD4 Expression and Early Systemic Tumor Recurrence in Resected Left-Sided Pancreatic Cancer. / Kang, ChangMoo; Hwang, Ho Kyoung; Park, Jiae; Kim, Changsoo; Cho, Seong Kyoung; Yun, Mijin; Lee, Woo Jung.

In: Medicine (United States), Vol. 95, No. 17, e3452, 01.04.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Maximum Standard Uptake Value as a Clinical Biomarker for Detecting Loss of SMAD4 Expression and Early Systemic Tumor Recurrence in Resected Left-Sided Pancreatic Cancer

AU - Kang, ChangMoo

AU - Hwang, Ho Kyoung

AU - Park, Jiae

AU - Kim, Changsoo

AU - Cho, Seong Kyoung

AU - Yun, Mijin

AU - Lee, Woo Jung

PY - 2016/4/1

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N2 - This study investigated the oncologic impact of loss of SMAD4 expression in resected left-sided pancreatic cancer and its correlation with tumor metabolism. From 2005 to 2011, the medical records of patients who underwent radical distal pancreatectomy for resectable pancreatic cancer were retrospectively reviewed. Formalin-fixed, paraffin embedded tissue from 32 patients was investigated. Clinicopathological characteristics, immunostaining of SMAD4, and positron emission tomography-based parameters were analyzed in relation to oncologic outcomes. Thirteen patients were women and 19 were men, with a mean age of 63 ± 9.4 years. Mean resected tumor size was 3.3 ± 1.5 cm. Ten patients (31.3%) showed loss of SMAD4 expression. No significant clinicopathological differences were noted according to SMAD4 expression (P > 0.05); however, patients with loss of SMAD4 showed significantly poorer disease-free survival (mean 57.4 months vs mean 17.6 months, P = 0.006). As a cut-off value, a SUV max of 4.5 was found to be predictive of loss of SMAD4 with a sensitivity of 75% and a specificity of 84.6%. In logistic regression analysis, SUV max >4.5 was found to infer a 16-fold higher risk for loss of SMAD4 in resected left-sided pancreatic cancers (Exp[β] = 16.5, P = 0.012, 95% confidence interval: 1.832-148.606). Loss of SMAD4 is associated with poor oncologic outcomes. SUV max can predict loss of SMAD4 in resected left-sided pancreatic cancer. SUV max may be a clinical biomarker for detecting loss of SMAD4 expression and predicting early systemic metastasis.

AB - This study investigated the oncologic impact of loss of SMAD4 expression in resected left-sided pancreatic cancer and its correlation with tumor metabolism. From 2005 to 2011, the medical records of patients who underwent radical distal pancreatectomy for resectable pancreatic cancer were retrospectively reviewed. Formalin-fixed, paraffin embedded tissue from 32 patients was investigated. Clinicopathological characteristics, immunostaining of SMAD4, and positron emission tomography-based parameters were analyzed in relation to oncologic outcomes. Thirteen patients were women and 19 were men, with a mean age of 63 ± 9.4 years. Mean resected tumor size was 3.3 ± 1.5 cm. Ten patients (31.3%) showed loss of SMAD4 expression. No significant clinicopathological differences were noted according to SMAD4 expression (P > 0.05); however, patients with loss of SMAD4 showed significantly poorer disease-free survival (mean 57.4 months vs mean 17.6 months, P = 0.006). As a cut-off value, a SUV max of 4.5 was found to be predictive of loss of SMAD4 with a sensitivity of 75% and a specificity of 84.6%. In logistic regression analysis, SUV max >4.5 was found to infer a 16-fold higher risk for loss of SMAD4 in resected left-sided pancreatic cancers (Exp[β] = 16.5, P = 0.012, 95% confidence interval: 1.832-148.606). Loss of SMAD4 is associated with poor oncologic outcomes. SUV max can predict loss of SMAD4 in resected left-sided pancreatic cancer. SUV max may be a clinical biomarker for detecting loss of SMAD4 expression and predicting early systemic metastasis.

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