@article{oai:shiga-med.repo.nii.ac.jp:00003458,
 author = {前平, 博充 and 三宅, 亨 and 飯田, 洋也 and 徳田, 彩 and 森, 治樹 and 安川, 大貴 and 向所, 賢一 and 清水, 智治 and 谷, 眞至 and MAEHIRA, Hiromitsu and MIYAKE, Toru and IIDA, Hiroya and TOKUDA, Aya and MORI, Haruki and YASUKAWA, Daiki and MUKAISHO, Ken-ichi and SHIMIZU, Tomoharu and TANI, Masaji},
 issue = {13},
 journal = {Annals of surgical oncology},
 month = {Dec},
 note = {BACKGROUND:The tumor microenvironment, including cancer-associated fibroblasts (CAFs), plays various clinical roles in cancer growth. CAFs are a heterogeneous population and express a variety of mesenchymal markers. However, the clinical roles for CAFs expressing different markers in pancreatic ductal adenocarcinoma (PDAC) remain unknown.

METHODS:We reviewed 67 resected PDAC patients who had not received preoperative therapy. Each primary tumor was analyzed for vimentin and α-smooth muscle actin (α-SMA) expression by immunohistochemical and dual immunofluorescence staining.

RESULTS:There was no correlation between the percentage of cells expressing vimentin and α-SMA in the tumor stroma (Pearson's correlation coefficient: r = 0.171). Higher vimentin expression (p = 0.018) was associated with significantly shorter overall survival in PDAC patients. Using dual immunofluorescence staining, vimentin-positive CAFs were divided into two subpopulations: co-expression of α-SMA, and no co-expression of α-SMA. In PDAC, the level of co-expression had no effect on survival using univariate analysis (median survival time, 33.3 months for low co-expression vs. 18.2 months for high co-expression; log-rank, p = 0.143). However, multivariate analysis clarified that CAFs expressing vimentin alone was an independent predictor of poor survival (p = 0.014; hazard ratio, 2.305; 95% confidence interval, 1.181-4.497).

CONCLUSIONS:Vimentin-positive CAFs without co-expression of α-SMA were associated with poor survival in PDAC, and CAFs possessed molecular and functional heterogeneity in this disease.},
 pages = {4791--4804},
 title = {Vimentin Expression in Tumor Microenvironment Predicts Survival in Pancreatic Ductal Adenocarcinoma: Heterogeneity in Fibroblast Population.},
 volume = {26},
 year = {2019}
}