Skip to main content

Advertisement

Log in

Positive Expression of L1-CAM is Associated with Perineural Invasion and Poor Outcome in Pancreatic Ductal Adenocarcinoma

  • Translational Research and Biomarkers
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Pancreatic ductal adenocarcinoma (PDAC) frequently invades and migrates along neural tissue, which results in local tumor recurrences, distant metastases, and poor prognosis. We evaluated whether L1 cell adhesion molecule (L1-CAM) and glial cell line-derived neurotrophic factor (GDNF) expression in PDAC correlated with neural invasion and overall survival on a large cohort of previously untreated patients.

Methods

L1-CAM and GDNF were examined by immunohistochemistry in pancreatic cancer tissue samples of 94 cases with PDAC on a tissue microarray. The molecular findings were correlated with pain, clinicopathologic characteristics, and overall survival in these patients.

Results

L1-CAM and GDNF were overexpressed in pancreatic cancer tissues compared with the adjacent normal tissues of pancreas. Positive L1-CAM expression was associated with node involvement (P = 0.007), vascular invasion (P = 0.012), perineural invasion (P = 0.001), and higher degree of pain (P = 0.005). In univariate analysis, tissue expression of L1-CAM was associated with poor survival (hazard ratio, 2.508; 95% confidence interval, 1.551–4.053; P < 0.001), and this was also significant in multivariate analysis (hazard ratio, 2.046; 95% confidence interval, 1.200–3.488; P = 0.009). Positive staining of GDNF, neural invasion, and vascular invasion were all statistically significantly related to unfavorable prognosis.

Conclusions

Enhanced expression of L1-CAM may contribute to the pain syndrome and perineural invasion and may correlate with poor overall survival in human pancreatic cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin. 2006;56:106–30.

    Article  PubMed  Google Scholar 

  2. Bergenfeldt M, Moesgaard F, Burcharth F. Curative resection for left-sided pancreatic malignancy. HPB (Oxford). 2006;8:211–5.

    Google Scholar 

  3. Schnelldorfer T, Ware AL, Sarr MG, et al. Long-term survival after pancreatoduodenectomy for pancreatic adenocarcinoma: is cure possible? Ann Surg. 2008;247:456–62.

    Article  PubMed  Google Scholar 

  4. Neoptolemos JP, Dunn JA, Stocken DD, et al. Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial. Lancet. 2001;358:1576–85.

    Article  PubMed  CAS  Google Scholar 

  5. Ozaki H, Hiraoka T, Mizumoto R, et al. The prognostic significance of lymph node metastasis and intrapancreatic perineural invasion in pancreatic cancer after curative resection. Surg Today. 1999;29:16–22.

    Article  PubMed  CAS  Google Scholar 

  6. Takahashi T, Ishikura H, Motohara T, et al. Perineural invasion by ductal adenocarcinoma of the pancreas. J Surg Oncol. 1997;65:164–70.

    Article  PubMed  CAS  Google Scholar 

  7. Bockman DE, Buchler M, Beger HG. Interaction of pancreatic ductal carcinoma with nerves leads to nerve damage. Gastroenterology. 1994;107:219–30.

    PubMed  CAS  Google Scholar 

  8. Nakajima S, Doi R, Toyoda E, et al. N-cadherin expression and epithelial-mesenchymal transition in pancreatic carcinoma. Clin Cancer Res. 2004;10:4125–33.

    Article  PubMed  CAS  Google Scholar 

  9. Kameda K, Shimada H, Ishikawa T, et al. Expression of highly polysialylated neural cell adhesion molecule in pancreatic cancer neural invasive lesion. Cancer Lett. 1999;137:201–7.

    Article  PubMed  CAS  Google Scholar 

  10. Ceyhan GO, Giese NA, Erkan M, et al. The neurotrophic factor artemin promotes pancreatic cancer invasion. Ann Surg. 2006;244:274–81.

    Article  PubMed  Google Scholar 

  11. Okada Y, Eibl G, Guha S, et al. Nerve growth factor stimulates MMP-2 expression and activity and increases invasion by human pancreatic cancer cells. Clin Exp Metastasis. 2004;21:285–92.

    Article  CAS  Google Scholar 

  12. Zhu Z, Friess H, diMola FF, et al. Nerve growth factor expression correlates with perineural invasion and pain in human pancreatic cancer. J Clin Oncol. 1999;17:2419–28.

    PubMed  CAS  Google Scholar 

  13. Hortsch M. Structural and functional evolution of the L1 family: are four adhesion molecules better than one? Mol Cell Neurosci. 2000;15:1–10.

    Article  PubMed  CAS  Google Scholar 

  14. Salton SR, Richter-Landsberg C, Greene LA, Shelanski ML. Nerve growth factor-inducible large external (NILE) glycoprotein: studies of a central and peripheral neuronal marker. J Neurosci. 1983;3:441–54.

    PubMed  CAS  Google Scholar 

  15. Fransen E, Lemmon V, Van Camp G, et al. CRASH syndrome: clinical spectrum of corpus callosum hypoplasia, retardation, adducted thumbs, spastic paraparesis and hydrocephalus due to mutations in one single gene, L1. Eur J Hum Genet. 1995;3:273–84.

    PubMed  CAS  Google Scholar 

  16. Kleene R, Yang H, Kutsche M, Schachner M. The neural recognition molecule L1 is a sialic acid-binding lectin for CD24, which induces promotion and inhibition of neurite outgrowth. J Biol Chem. 2001;276:21656–63.

    Article  PubMed  CAS  Google Scholar 

  17. Thies A, Schachner M, Moll I, et al. Overexpression of the cell adhesion molecule L1 is associated with metastasis in cutaneous malignant melanoma. Eur J Cancer. 2002;38:1708–16.

    Article  PubMed  CAS  Google Scholar 

  18. Fogel M, Mechtersheimer S, Huszar M, et al. L1 adhesion molecule (CD 171) in development and progression of human malignant melanoma. Cancer Lett. 2003;189:237–47.

    Article  PubMed  CAS  Google Scholar 

  19. Kaifi JT, Reichelt U, Quaas A, et al. L1 is associated with micrometastatic spread and poor outcome in colorectal cancer. Mod Pathol. 2007;20:1183–90.

    Article  PubMed  CAS  Google Scholar 

  20. Gavert N, Sheffer M, Raveh S, et al. Expression of L1-CAM and ADAM10 in human colon cancer cells induces metastasis. Cancer Res. 2007;67:7703–12.

    Article  PubMed  CAS  Google Scholar 

  21. Wachowiak R, Fiegel HC, Kaifi JT, et al. L1 is associated with favorable outcome in neuroblastomas in contrast to adult tumors. Ann Surg Oncol. 2007;14:3575–80.

    Article  PubMed  Google Scholar 

  22. Allory Y, Matsuoka Y, Bazille C, et al. The L1 cell adhesion molecule is induced in renal cancer cells and correlates with metastasis in clear cell carcinomas. Clin Cancer Res. 2005;11:1190–7.

    PubMed  CAS  Google Scholar 

  23. Zecchini S, Bianchi M, Colombo N, et al. The differential role of L1 in ovarian carcinoma and normal ovarian surface epithelium. Cancer Res. 2008;68:1110–8.

    Article  PubMed  CAS  Google Scholar 

  24. Fogel M, Gutwein P, Mechtersheimer S, et al. L1 expression as a predictor of progression and survival in patients with uterine and ovarian carcinomas. Lancet. 2003;362:869–75.

    Article  PubMed  CAS  Google Scholar 

  25. Issa Y, Nummer D, Seibel T, et al. Enhanced L1CAM expression on pancreatic tumor endothelium mediates selective tumor cell transmigration. J Mol Med. 2009;87:99–112.

    CAS  Google Scholar 

  26. Okada Y, Takeyama H, Sato M, et al. Experimental implication of celiac ganglionotropic invasion of pancreatic-cancer cells bearing c-ret proto-oncogene with reference to glial-cell-line-derived neurotrophic factor (GDNF). Int J Cancer. 1999;81:67–73.

    Article  PubMed  CAS  Google Scholar 

  27. Iwahashi N, Nagasaka T, Tezel G, et al. Expression of glial cell line-derived neurotrophic factor correlates with perineural invasion of bile duct carcinoma. Cancer. 2002;94:167–74.

    Article  PubMed  CAS  Google Scholar 

  28. Veit C, Genze F, Menke A, et al. Activation of phosphatidylinositol 3-kinase and extracellular signal-regulated kinase is required for glial cell line-derived neurotrophic factor-induced migration and invasion of pancreatic carcinoma cells. Cancer Res. 2004;64:5291–300.

    Article  PubMed  CAS  Google Scholar 

  29. Okada Y, Eibl G, Duffy JP, Reber HA, Hines OJ. Glial cell–derived neurotrophic factor upregulates the expression and activation of matrix metalloproteinase-9 in human pancreatic cancer. Surgery. 2003;134:293–9.

    Article  PubMed  Google Scholar 

  30. Sobin LH. TNM, sixth edition: new developments in general concepts and rules. Semin Surg Oncol. 2003;21:19–22.

    Article  PubMed  Google Scholar 

  31. Koide N, Yamada T, Shibata R, et al. Establishment of perineural invasion models and analysis of gene expression revealed an invariant chain (CD74) as a possible molecule involved in perineural invasion in pancreatic cancer. Clin Cancer Res. 2006;12:2419–26.

    Article  PubMed  CAS  Google Scholar 

  32. Bachmann IM, Halvorsen OJ, Collett K, et al. EZH2 expression is associated with high proliferation rate and aggressive tumor subgroups in cutaneous melanoma and cancers of the endometrium, prostate, and breast. J Clin Oncol. 2006;24:268–73.

    Article  PubMed  CAS  Google Scholar 

  33. Luo J, Zha S, Gage WR, et al. Alpha-methylacyl-CoA racemase: a new molecular marker for prostate cancer. Cancer Res. 2002;62:2220–6.

    PubMed  CAS  Google Scholar 

  34. Kozarek RA. Endoscopy in the management of malignant obstructive jaundice. Gastroint Endosc Clin N Am. 1996;6:153–76.

    CAS  Google Scholar 

  35. Nitecki SS, Sarr MG, Colby TV, van Heerden JA. Long-term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving? Ann Surg. 1995;221:59–66.

    Article  PubMed  CAS  Google Scholar 

  36. Nagakawa T, Mori K, Nakano T, et al. Perineural invasion of carcinoma of the pancreas and biliary tract. Br J Surg. 1993;80:619–21.

    Article  PubMed  CAS  Google Scholar 

  37. Lindner J, Rathjen FG, Schachner M. L1 mono- and polyclonal antibodies modify cell migration in early postnatal mouse cerebellum. Nature. 1983;305:427–30.

    Article  PubMed  CAS  Google Scholar 

  38. Rathjen FG, Rutishauser U. Comparison of two cell surface molecules involved in neural cell adhesion. EMBO J. 1984;3:461–5.

    PubMed  CAS  Google Scholar 

  39. Chang S, Rathjen FG, Raper JA. Neurite outgrowth promoting activity of G4 and its inhibition by monoclonal antibodies. J Neurosci Res. 1990;25:180–6.

    Article  PubMed  CAS  Google Scholar 

  40. Ridder GJ, Klempnauer J. Back pain in patients with ductal pancreatic cancer. Its impact on resectability and prognosis after resection. Scand J Gastroentrol. 1995;30:1216–20.

    Article  CAS  Google Scholar 

  41. Dahme M, Bartsch U, Martini R, et al. Disruption of the mouse L1 gene leads to malformations of the nervous system. Nat Genet. 1997;17:346–9.

    Article  PubMed  CAS  Google Scholar 

  42. Yamanaka H, Obata K, Kobayashi K, et al. Alteration of the cell adhesion molecule L1 expression in a specific subset of primary afferent neurons contributes to neuropathic pain. Eur J Neurosci. 2007;25:1097–111.

    Article  PubMed  Google Scholar 

  43. Ohyama R. Clinicopathological studies on carcinoma of the pancreas with special reference to pathological factors affecting the prognosis and lymph node involvement. Nippon Geka Gakkai Zasshi. 1984;85:820–34.

    PubMed  CAS  Google Scholar 

  44. Matsuda M, Nimura Y. Perineural invasion of carcinoma of the head of the pancreas. Jpn J Surg. 1983;84:719–28 (abstract in English).

    Google Scholar 

  45. Gavert N, Conacci-Sorrell M, Gast D, et al. L1, a novel target of beta-catenin signaling, transforms cells and is expressed at the invasive front of colon cancers. J Cell Biol. 2005;168:633–42.

    Article  PubMed  CAS  Google Scholar 

  46. Meier F, Busch S, Gast D, et al. The adhesion molecule L1 (CD171) promotes melanoma progression. Int J Cancer. 2006;119:549–55.

    Article  PubMed  CAS  Google Scholar 

  47. Shtfutman M, Levina E, Ohouo P, Baig M, Roninson IB. Cell adhesion molecule L1 disrupts E-cadherin-containing adherens junctions and increases scattering and motility of MCF7 breast carcinoma cells. Cancer Res. 2006;66:11370–80.

    Article  Google Scholar 

Download references

Acknowledgment

We thank Ai-Ying Zeng (University of Fudan) and Fangjun Wan (Ruijin Hospital) for their skillful technical assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yao-Zong Yuan MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ben, QW., Wang, JC., Liu, J. et al. Positive Expression of L1-CAM is Associated with Perineural Invasion and Poor Outcome in Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol 17, 2213–2221 (2010). https://doi.org/10.1245/s10434-010-0955-x

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-010-0955-x

Keywords

Navigation