A New Stage Classification of Pancreatic Cancer Including Cytomolecular Factors

本项目旨在开发一种新的胰腺癌临床分期。以前的分类只包括临床病理因素，但胰腺癌并不总是以这个标准分期来分类，因为胰腺癌具有极高的恶性潜能。在本研究中，我们利用多种基因技术和免疫组织化学方法，结合单克隆抗体，对胰腺癌的细胞分子背景进行了研究。细胞分子因素包括Ki-ras点突变和p53抑癌基因产物、EGF及其受体、纤维连接蛋白和Ki-ras p21的表达。结果表明，p53抑癌基因产物的表达、EGF和EGF受体的共同表达以及Ki-ras双突变可作为胰腺癌患者预后不良的指标，而与肿瘤侵袭深度、淋巴结转移或远处转移等临床病理因素无关，提示这些细胞分子指标有助于预测胰腺癌患者的预后，临床分期应包括这些指标的状态。

The present project was designed to develope a new clinical stage classification of pancreatic cancer. The previous classification included just clinicopathological factors, but pancreatic cancer can not always be classified by this standard stage, because pancreatic cancer shows extremely malignant potentials. In the present study, we assessed the cytomolecular backgrounds of pancreatic cancer using various gene techniques and immunohistochemistry with monoclonal antibodies. The cytomolecular factors included Ki-ras point mutation and the expression of p53 tumor suppressor gene product, EGF and its receptor, fibronectin and Ki-ras p21.The results show that the expression of p53 tumor suppressor gene product, coexpression of EGF and EGF-receptor, and Ki-ras double mutation were suggested to be the indicators for poor prognosis of the patients with pancreatic cancer, independently of clinicopathological factors such as depth of tumor invasion, nodal involvement or distant metastasis.We conclude that these cytomolecular parameters are beneficial to predict the prognosis of the pancreatic cancer patients and the clinical stage should include the status of these parameters.