Relationship Between Perineural Invasion and Expression of Neuro-endocrine Markers and Neural Cell Adhesion Molecule in Human Pancreatic Carcinoma

Abstract

Perineural invasion is one of the significant prognostic factors of pancreatic carcinoma. To clarify the relationship between the expression of neuro-endocrine (NE) markers and perineural invasion in human pancreatic carcinoma, tissue specimens from a series of 19 patients who were operated between January 1983 and August 1989 in our department were stained immunohistochemically with specific NE markers (i.e., NSE, Synaptophysin, Chromogranin, S-100 protein, Substance-P, Enkephaline) and with neural cell adhesion molecule (NCAM) MoAb. The staining method was immunoperoxidase staining with avidin-biotinylated peroxidase complexes. There were no carcinoma cells stained by NSE or Chromogranin in any specimens. Any specimens from 11 cases were positively stained by NCAM MoAb and at least one of 4 NE markers. On the other hand, 8 patients were negative for all of them. Specimens from 16 patients (84%) revealed perineural invasion when stained with hematoxylin and eosin. Perineural invasion of pancreatic carcinoma was significantly related to the expression of NCAM and 4 NE markers (p<0.01). In particulary, the expression rate was increased in carcinoma cells which invaded the perineural space. NCAM-positive patients showed much less a liver metastasis and had a better prognosis than NCAM negative patients. Our results indicate that NE differentiation may occur in some pancreatic carcinoma cells and especially that NCAM may be involved in perineural invasion through its neural affinity. Pancreatic carcinoma cells which express NCMA may have nerual affinity.