Prognostic Significance Of CSPG4 Overexpression In Pancreatic Carcinoma Patients

Objectives: To investigate the expression status and clinical significance of Chondroitin Sulfate Proteoglycan 4(CSPG4) in pancreatic carcinoma.Methods: The expression level of CSPG4 mRNA and protein was detected with quantitative real-time PCR(q RT-PCR) and immunohistochemical staining in 80 cases of pancreatic ductal adenocarcinoma(PDAC) samples and 80 cases of corresponding adjacent normal samples. The correlations between clinicopathologic features of the patients with pancreatic carcinoma and the expression level of CSPG4 m RNA and protein were analyzed. Kaplan-Meier method was used to evaluate the impact of CSPG4 mRNA and protein expression level on postoperative survival of patients with pancreatic carcinoma. Cox proportional hazard regression model was utilized to carry out the univariate and multivariate prognostic analyses, and explore the factors that influence the prognosis of patients with pancreatic carcinoma.Result: The relative expression level of CSPG4 m RNA was significantly higher in PDAC samples than that in corresponding adjacent normal samples [25.05(14.91-49.67) vs. 14.17(5.27-28.20), P<0.001]. The positive rate of CSPG4 protein expression was significantly higher in PDAC samples than that in corresponding adjacent normal samples(46.25% vs. 10.00%, P<0.001). Remarkable correlations exist in the expression of CSPG4 mRNA with lymph node metastasis(P=0.030), vascular invasion(P=0.040), T stage(P=0.001) as well as TNM stage(P<0.001). Remarkable correlations were found between the expression of CSPG4 protein and lymph node metastasis(P=0.032), vascular invasion(P=0.026), T stage(P=0.004) as well as TNM stage(P=0.001). Kaplan-Meier survival analysis showed that the overall survival of patients with CSPG4 m RNA high expression was much lower than that of patients with CSPG4 m RNA low expression(P<0.001). The overall survival of patients with CSPG4 protein positive expression was much lower than that of patients with CSPG4 protein negative expression(P<0.001). COX univariate analysis revealed that lymph node metastasis(P=0.001), vascular invasion(P=0.006), T stage(P=0.015), TNM stage(P=0.006), the expression level of CSPG4 m RNA(P<0.001) and protein(P<0.001) were all factors that influence the prognosis of patients with pancreatic carcinoma. Furthermore, COX multivariate regression analysis showed that lymph node metastasis(P=0.004), the expression level of CSPG4 m RNA(P=0.013) and protein(P=0.037) were assigned as independent risk factors which could significantly affect the prognosis of pancreatic carcinoma patients.Conclusion: CSPG4 is over-expressed in PDAC. It may play a key role in pancreatic carcinoma, involving its occurrence, development and malignant progress. The CSPG4 expression in pancreatic carcinoma is important in assessing postoperative survival of patients, and it could be an independent predictor to assess the prognosis of patients with pancreatic carcinoma. CSPG4 seems to be a potential target for immunotherapy of pancreatic carcinoma.