Paucity of dendritic cells in pancreatic cancer

doi:10.1067/msy.2002.119937

Surgery

Volume 131, Issue 2, February 2002, Pages 135-138

https://doi.org/10.1067/msy.2002.119937 Get rights and content

Abstract

Background. The number of dendritic cells (DC) in the local tumor environment correlates with patient survival in numerous tumors. The relationship of DC infiltration in the tumor microenvironment and prognosis was examined in patients with pancreatic adenocarcinoma. Methods. Forty-seven pancreatectomy specimens with a diagnosis of pancreatic adenocarcinoma were identified retrospectively and analyzed with the dendritic cell markers S-100 and CD1a. Patient survival was correlated with these markers and with p53, CD3, CD20, CD68, Ki-67. Results. Significant numbers (>3 per high-powered field) of tumor-associated S100⁺ or CD1a⁺ cells were found in only 2/47 patients (4%). When present, dendritic cells were located outside the margin of the tumor. CD3, CD68, and CD20 positive cells were rare or absent in 96%, 92%, and 93% of the specimens. A correlation with survival and numbers of immune cells could not be made secondary to their rarity. The median survival was 18.9 months. No other indices measured correlated with survival. Conclusions. In patients with pancreatic adenocarcinoma, there is a paucity of immune cells within the tumor. (Surgery 2002;131:135-8.)

Section snippets

Patient selection

A computerized search of operative reports at the University of Pittsburgh Medical Center from January 1990 to 1997 revealed 49 patients who had curative pancreatic resection for adenocarcinoma (48 Whipple specimens and 1 distalpancreatectomy). Of these, 2 were lost to follow-up. Follow-up was obtained through tumor registry, death certificates, and office records.

Histopathology

The 47 specimens were fixed in 10% neutral buffered formalin solution, routinely processed, and embedded with paraffin. Routine

Statistical method

We applied the Fisher exact test to categorical variables to determine whether associations exist among independent variables. We also used analysis of variance to evaluate whether distributions of continuous variables, tumor size, and Ki-67, differed significantly across levels of categorical variables. After analyzing the association among independent variables, we used the Cox proportional hazards model to assess the impact of independent variables on patient survival.

Patients

Of the 47 patients, 37 died during the follow-up period. Ten patients were right-censored. The median time to death was 13.4 months in the 37 patients known to have died, and the minimum and maximum times were 2.7 and 160.8 months, respectively. Among the 10 patients who were right-censored, the mean and median length of follow-up was 32.7 ± 15.9 months and 29.0 months, respectively. Based on Kaplan-Meier estimation of the survival function, median overall survival was estimated as 18.9 months

Discussion

Several previous studies have correlated intratumoral DC infiltrate and survival. We had hoped to demonstrate this effect in patients with pancreatic cancer, but we found only rare instances of significant DC infiltrate. Compared with other series, we had to devise a substantially more sensitive grading system. CD1a stains Langerhans' DC and is more specific (but less sensitive) than S100, which accounts for the greater number of S100⁺ cells. With these DC markers (S100, CD1a), significant

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^*: Supported in part by a grant from the National Institute of Health PO1-CA73743 and the Society of University Surgeons Fellowship grant.

^**: Reprint requests: Ramsey M. Dallal, MD, 200 Lothrop St, 677 Scaife Hall, Department of Surgery, Pittsburgh, PA 15261.

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Original CommunicationsPaucity of dendritic cells in pancreatic cancer*,**

Abstract

Section snippets

Patient selection

Histopathology

Statistical method

Patients

Discussion

Eur J Cancer

Pathology

Pathology

Cancer statistics, 1999

CA Cancer J Clin

Bone marrow-derived dendritic cells pulsed with tumor peptides effectively treat established murine tumors

Nat Med

Langerhans cells related to prognosis in patients with laryngeal carcinoma

Arch Otolaryngol Head Neck Surg

S-100 protein-positive dendritic cells in colorectal adenocarcinomas

Cancer

Dendritic cells prevent lymph node metastasis in patients with gastric cancer

In Vivo

Original Communications
Paucity of dendritic cells in pancreatic cancer*,**