Investigation On Relations Between Perineural Invasion (PNI)of Pancreatic Carcinoma And Clinicopathological Parameters

Objective:To investigate the relations between perineural invasion (PNI) of pancreatic carcinoma and clinicopathological parameters, and to analyze their clinical contributions.Methods:A total of215cases of pancreatic ductal adenocarcinoma operated between2005and2010at Huashan Hospital of Fudan University were included. Paraffin embedded sections were re-evaluated and stratified according to PNI status, with118PNI positive and97negative. Preoperative FBS value, serum amylase level, serum CA19-9level, presentations of abdominal pain, back pain, as well as complete pathological parameters including grading, staging, nodal invasion, local invasion were involved for analysis. Immunohistochemical staining of P53and Ki67were studied semiquantatively. All aforementioned parameters were re evaluated retrospectively for correlation.Results:1. Preoperative FBS level increased with promotion of pathological grading (P<0.05). FBS level was significantly higher in PNI patients than control (P<0.05).2. PNI was significantly related to symptoms of referred pain (P<0.05).3. Preoperative CA19-9level increased with promotion of pathological grading (P<0.05). FBS level was significantly higher in PNI patients than control (P<0.05).4. Expression of P53increased by grading (P<0.05) and was significantly higher in PNI patients (P<0.05) and nodal positive subjects (P<0.05).5. Expression of Ki67was significantly higher in PNI patients (P<0.05).6. Incidence of PNI significantly increased with increased grading (P <0.05).Conclusion:1. Preoperative FBS level, serum CA19-9level and, symptom of referred pain are indicative for possible PNI in pancreatic carcinoma. 2. P53and Ki67may play critical role in the molecular mechanism of PNI in pancreatic carcinoma.