The Expression And Clinical Significance Of Livin, Caspase-3 And PCNA Protein In Pancreatic Carcinoma Using Tissue Microarray

Objective: To investigate the expression of Livin,Caspase-3 and proliferating cell nuclear antigen(PCNA) protein in pancreatic ductal adenocarcinoma(PDAC) with high-throughput tissue microarray technique, and to explore their relationship with clinicopathologic parameters and the prognostic significance in PDAC.Methods: Immunohistochemistry was used to examine the expression of Livin,Caspase-3 and PCNA protein in tissues from 88 cases of pancreatic adenocarcinoma without a history of chemo-radiation therapy and 11 cases from non tumorous pancreatic tissues,the relationship of these subjects was analyzed with spearman rank correlation. Among these 88 cases of PDAC, 54 cases were followed-up from 2 months to 6 years, in which the prognosis was analyzed.Results: A paraffin-embedded pancreatic carcinoma tissue microarray was successfully constructed, including 99 tissue spots. Positive expression of Livin and PCNA in tumors was showed 76.1%(67/88) and 73.9%(65/88), respectively, the expression of Caspase-3 was much higher in non tumorous pancreatic tissues (90.9%, 10/11) than in carcinoma (40.9%, 36/88), statistical significance was found in all of these differences (P<0.01). Livin expression was significantly correlated with sex, TNM stage and lymph node metastasis (P<0.05), but there was no distinct difference in age, tumor location and histological grade (P>0.05). The expression of Caspase-3 and PCNA was significantly related to histological grade, TNM stage and lymph node metastasis (P<0.01), and Caspase-3 expression was also related to sex (P<0.01), but both of them were unrelated to age, tumor location and size (P>0.05). Spearman rank correlation showed a significant cooperativity among Livin, Caspase-3 and PCNA protein (P<0.01). In 54 cases of PDAC with followed-up data, univariant analysis revealed that the survival rate was correlated with expression of Livin and PCNA, as well as lymph node metastasis (P<0.05), but Caspase-3 expression, sex, age, tumor location, size, histological grade and TNM stage were unrelated to prognosis (P>0.05). Furthermore, Cox stepwise proportional hazards analysis showed that only Livin status retained independent significance in prospecting prognosis of PDAC.Conclusion: Tissue microarray technique is an effective method to detect multiple gene protein expression. The expression of Livin and PCNA was associated with clinicopathologic parameters and prognosis in pancreatic carcinoma. High expression of Livin in patients with PDAC implied poor prognosis, which can become a independent index for tumor prognosis. Caspase-3 may join in the regulation of apoptosis and the progression of pancreatic carcinoma.