Expression and Clinical Significance of Pepsinogen C in Resectable Pancreatic Cancer

Abstract

Pepsinogen C is an aspartyl-proteinase usually involved in the digestion of proteins in the stomach, and an androgen- inducible protein in breast cancer cells. In this study we evaluated its expression and clinical significance in patients with resectable pancreatic cancer. Pepsinogen C expression was examined by immunohistochemical methods in a series of 73 pancreatic carcinomas. The prognostic value of pepsinogen C was retrospectively evaluated by multivariate analysis. A total of 21 (28.8%) pancreatic carcinomas stained positively for pepsinogen C. The percentage of pepsinogen C-positive tumors was significantly higher in well-differentiated tumors (38.3%) than in moderately differentiated (15.8%) and poorly differentiated (O%) tumors (p<0.05). In addition, statistical analysis revealed that pepsinogen C expression was associated with clinical outcome. Thus, patients with pepsinogen C-negative tumors have a poorer overall survival than those with pepsinogen C-positive tumors. Our results led us to consider that the expression of pepsinogen C may represent a useful biological marker in pancreatic cancer. Expression of this protein may be a marker of gastric-type differentiation of the tumors and it might also reflect the existence of a complete hormone receptor pathway in a subset of pancreatic carcinomas.

Gene Expression Profiling Identifies Genes Associated with Invasive Intraductal Papillary Mucinous Neoplasms of the Pancreas

“…32 Furthermore, pepsinogen C is known to be a strong predictor for favorable outcome in patients with various cancers, including breast, 57 gastric, 58 and pancreatic cancer. 59 Based on these findings, it is possible that consistent overexpression of these gastric-type proteins in IPMNs is related to their indolent biological behavior and relatively favorable outcome.…”

PGC TagSNP and Its Interaction with H. pylori and Relation with Gene Expression in Susceptibility to Gastric Carcinogenesis

“…Our research group previously found that histological PGC protein expression gradually declined with the cellular malignant transformation from the originally normal state to inflammation, precancerous conditions and finally to carcinoma. Additionally, several previous studies in extragastric tissues reported that low-expression of PGC protein was closely related to poor differentiation and unflavored survival in patients with breast, prostate, ovarian, or pancreatic cancers [5] – [8] . These evidences exhibited that PGC has a general role in suppressing the tumor development.…”

Serum pepsinogen level, atrophic gastritis and the risk of incident pancreatic cancer—A prospective cohort study

“…Helicobacter pylori ( H. pylori ) seropositivity was also associated with a significant elevated risk of pancreatic cancer 8,9 and Helicobacter species DNA have also been isolated from pancreatic cancer tissue 10,11. Furthermore, pepsinogen expression by pancreatic cancer cells was found in 38% of well-differentiated, resectable cancers and portends a better overall survival compared to others without the expression 12. Gastrin, a gastrointestinal peptide, has also been shown to have a proliferative effect on pancreatic cancer cells.…”