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©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Relationship between cachexia and perineural invasion in pancreatic adenocarcinoma
Livia Petrusel, Ioana Rusu, Daniel Corneliu Leucuta, Radu Seicean, Ramona Suharoschi, Paula Zamfir, Andrada Seicean
Livia Petrusel, Andrada Seicean, Department of Gastroenterology, Regional Institute of Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca 400162, Romania
Ioana Rusu, Paula Zamfir, Department of Pathology, Regional Institute of Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca 400162, Romania
Daniel Corneliu Leucuta, Medical Informatics and Biostatistics Department, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca 400012, Romania
Radu Seicean, First Surgery Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca 400006, Romania
Ramona Suharoschi, Faculty of Food Science and Technology, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Cluj-Napoca 400372, Romania
Author contributions: Petrusel L and Seicean A conceived and designed the study; Petrusel L, Rusu I, Seicean R, Suharoschi R and Zamfir P performed the research; Leucuta DC analysed data; Petrusel L and Seicean A wrote the paper.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Regional Institute of Gastroenterology and Hepatology in Cluj-Napoca.
Conflict-of-interest statement: The authors report no relevant conflicts of interest.
Data sharing statement: Participants gave written informed consent for data sharing.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Livia Petrusel, MD, PhD, Doctor, Regional Institute of Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy, 19-21 Croitorilor Street, Cluj-Napoca 400162, Romania. livia.cutas@umfcluj.ro
Telephone: +40-72-4402389
Received: May 5, 2019
Peer-review started: May 8, 2019
First decision: July 31, 2019
Revised: September 9, 2019
Accepted: October 14, 2019
Article in press: October 14, 2019
Published online: December 15, 2019
ARTICLE HIGHLIGHTS
Research background
Pancreatic cancer has a high mortality rate, due to late diagnosis. Cachexia and perineural invasion have an increased incidence in pancreatic cancer, leading to decreased quality of life. Combating pain and cachexia through optimal treatment options can lead to increased quality of life and improved survival.
Research motivation
We wanted a better understanding of the involvement of cachexia and pain in pancreatic cancer and their relationship with different clinico-pathological factors, constituting a basis for discovering new therapeutic targets.
Research objectives
Defining the profile of cachexia in pancreatic cancer; establishing the degree of perineural invasion in pancreatic cancer; Highlighting the interrelationship between cachexia and perineural invasion in pancreatic cancer.
Research methods
We conducted a prospective study in 114 patients with pancreatic cancer and 125 healthy people as controls. Blood samples were used and pancreatic tissue were collected through EUS-FNA or surgery. The method of determining the biomarkers of cachexia (Activin) and perineural invasion (Midkine) in plasma was western blot, respectively immunohistochemistry in pancreatic tissue.
Research results
The analysis of the data showed an Activin (ACV) and Midkine (MK) proteins overexpression in plasma of patients with pancreatic cancer vs control, results that were correlated with the expression of proteins in the pancreatic cancer tissue. MK was also significantly correlated with advanced T stage, metastasis, diabetes and perineural invasion. ACV was significantly correlated with survival.
Research conclusions
MK can be considered a biomarker for perineural invasion, and ACV a prognostic factor for patients with pancreatic cancer.
Research perspectives
This research would open new perspectives in choosing the treatment that involves activin antagonists in order to prolong survival in patients with pancreatic cancer.
