This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Systematic review of immunohistochemical biomarkers to identify prognostic subgroups of patients with pancreatic cancer. BJS 2011; 98: 1041-1055.
Published: 6th June 2011
Authors: D. Ansari, A. Rosendahl, J. Elebro, R. Andersson
Background
Pancreatic ductal adenocarcinoma (PDAC) carries a dismal prognosis. There is a need to identify prognostic subtypes of PDAC to predict clinical and therapeutic outcomes accurately, and define novel therapeutic targets. The purpose of this review was to provide a systematic summary and review of available data on immunohistochemical (IHC) prognostic and predictive markers in patients with PDAC.
Method
Relevant articles in English published between January 1990 and June 2010 were obtained from PubMed searches. Other articles identified from cross‐checking references and additional sources were reviewed. The inclusion was limited to studies evaluating IHC markers in a multivariable setting.
Results
Database searches identified 76 independent prognostic and predictive molecular markers implicated in pancreatic tumour growth, apoptosis, angiogenesis, invasion and resistance to chemotherapy. Of these, 11 markers (Ki‐67, p27, p53, transforming growth factor β1, Bcl‐2, survivin, vascular endothelial growth factor, cyclo‐oxygenase 2, CD34, S100A4 and human equilibrative nucleoside transporter 1) provided independent prognostic or predictive information in two or more separate studies.
Conclusion
None of the molecular markers described can be recommended for routine clinical use as they were identified in small cohorts and there were inconsistencies between studies. Their prognostic and predictive values need to be validated further in prospective multicentre studies in larger patient populations. A panel of molecular markers may become useful in predicting individual patient outcome and directing novel types of intervention. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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