Involvement of Adrenomedullin Expression in Tumor Cells and Stroma in the Development of Diabetes in Pancreatic Cancer Patients

Abstract

Some studies have reported that adrenomedullin AM is involved in diabetes mellitus DM associated with pancreatic cancer. Therefore, in this study we investigated the relationship between diabetes and AM expression in patients with pancreatic cancer. We examined 48 biopsies and 26 surgical resections from 74 patients with histologically diagnosed pancreatic cancer. Patients were classi ed into either DM or non-DM groups. The immunohistochemical expression of AM and various clinicopathological factors were compared between the two groups. Among the biopsy cases, 21 were classified as DM and 27 as non-DM. AM expression in pancreatic cancer cells was significantly lower in the DM group p 0.03 . No signi cant differences were noted in age, body mass index, tumor diameter or location, serum CA19-9, amylase, or C-reactive protein levels, pancreatic ductal dilatation, portal vein invasion, clinical stage, or histological differentiation between the DM and non-DM groups. The proportion of men was signi cantly lower in the DM group p 0.04 , as was the frequency of liver metastasis at diagnosis p 0.03 . Among the resection cases, 13 were classi ed as DM and 13 as non-DM. There were no signi cant differences in AM expression in pancreatic cancer cells between the two groups. However, marked AM expression was observed in the in ammatory cells and broblasts of the tumor stroma in all cases. In addition, the in ammatory response in the tumor stroma tended to be stronger in the DM group. Although the present study failed to nd a positive correlation between diabetes and AM expression in pancreatic cancer cells, the results indicate that AM expression in stromal cells may be more closely related to the development of DM in pancreatic cancer patients.