L. A. Shirley1, B. Swanson2, W. Frankel2, T. Bekaii-Saab3, M. Bloomston1, C. Chen4 1Ohio State University Wexner Medical Center,Surgical Oncology,Columbus, OH, USA 2Ohio State University Wexner Medical Center,Pathology,Columbus, OH, USA 3Ohio State University Wexner Medical Center,Medical Oncology,Columbus, OH, USA 4Ohio State University College Of Pharmacy,Medicinal Chemistry,Columbus, OH, USA
Introduction: Intraductal papillary mucinous neoplasms (IPMNs) are pre-malignant lesions of the pancreas that are typically found incidentally. The presence of an IPMN presents a clinical dilemma in that it is difficult to predict which patients will go on to succumb to pancreatic cancer. Integrin-linked kinase (ILK) is a serine-threonine kinase known to be overexpressed in pancreatic cancer, correlating with worse survival. We examined resected pancreata with IPMN to see if similar correlations exist.
Methods: Intraductal papillary mucinous neoplasms (IPMNs) are pre-malignant lesions of the pancreas that are typically found incidentally. The presence of an IPMN presents a clinical dilemma in that it is difficult to predict which patients will go on to succumb to pancreatic cancer. Integrin-linked kinase (ILK) is a serine-threonine kinase known to be overexpressed in pancreatic cancer, correlating with worse survival. We examined resected pancreata with IPMN to see if similar correlations exist.
Results: In our cohort, 10 samples (35.7%) had an invasive component. Mean IPMN ILK score was 0.56, while mean stromal ILK score was 1.96. If an invasive component was present, the mean ILK score in this region was 0.6. There was no correlation between IPMN (P=0.46) or invasive component (P=0.55) ILK scores and patient survival. However, high ILK expression (score of 3) in the stroma surrounding the IPMN was associated with a significantly worse overall survival (median survival not reached vs. 33.5 months, 5-year survival 69.8% vs. 22.2%, P=0.016) (Figure 1). This correlation remained significant when stratified by the presence of an invasive component (non-invasive median survival not reached vs. 39.6 months, 5-year survival 75.2% vs. 50%, invasive median survival 62.6 vs. 19.9 months, 5-year survival 60% vs. 0%, P=0.029).
Conclusion: Stromal ILK over-expression in IPMNs was associated with worse survival, independent of the presence of an invasive component. Stromal ILK expression could be used in the future as a marker to stratify patients with IPMNs that need more aggressive therapy. Additionally, targeting ILK overexpression may provide a novel therapeutic strategy.
