Extrapancreatic Neuropathy Correlates with Early Liver Metastasis in Pancreatic Head Adenocarcinoma

Meng Lu; Dian-Rong Xiu; Li-Mei Guo; Chun-Hui Yuan; Ling-Fu Zhang; Lian-Yuan Tao

doi:10.2147/OTT.S221844

Extrapancreatic Neuropathy Correlates with Early Liver Metastasis in Pancreatic Head Adenocarcinoma

Onco Targets Ther. 2019 Dec 16:12:11083-11095. doi: 10.2147/OTT.S221844. eCollection 2019.

Authors

Meng Lu¹, Dian-Rong Xiu², Li-Mei Guo³, Chun-Hui Yuan², Ling-Fu Zhang², Lian-Yuan Tao²

Affiliations

¹ Department of Pulmonary Oncology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, People's Republic of China.
² Department of General Surgery, Peking University Third Hospital, Beijing, People's Republic of China.
³ Department of Pathology, Peking University Third Hospital, Beijing, People's Republic of China.

Abstract

Background: Pancreatic ductal adenocarcinoma has a devastatingly poor prognosis, and most prognostic factors reflected the tumor stage more than the tumors' biology. The peripheral nerve plexus is densely distributed in the tumor micro-environment, and there are interactions between tumor cells and these nerves. Perineural invasion is an important risk factor for tumor recurrence and metastasis in pancreatic head adenocarcinoma, but the concrete types of extrapancreatic neuropathy and its role in predicting prognosis are still not clear.

Objective: To clarify the role of extrapancreatic neuropathy in the early postoperative liver metastasis and tumor-related mortality in pancreatic head adenocarcinoma and to study the mechanism of tumor recurrence and liver metastasis in pancreatic head adenocarcinoma.

Methods: We reported a retrospective study of 60 patients with resectable pancreatic head adenocarcinoma, all of whom accepted radical pancreaticoduodenectomy. Plexus pancreaticus capitalis II (PLX-II) was the representation of extrapancreatic plexus in our study, and all of these plexus had immunohistochemical staining. We defined the postoperative tumor recurrence and tumor-related mortality within 6 months as the early prognostic indicators and analyzed the pathological alterations in PLX-II among different prognosis groups.

Results: There were 18 patients suffering early postoperative liver metastasis; these two groups differed significantly in the average number of nerve trunks (P<0.001), the proportion of neuritis (P=0.003), the content of sympathetic nerve fibers (P=0.004) and parasympathetic nerve fibers (P<0.001) per unit area of PLX-II. There were 15 patients suffering early postoperative mortality, and there were significant differences between these two groups in the average number of nerve trunks (P<0.001), the proportion of neuritis (P=0.009), the content of sympathetic nerve fibers (P=0.023) and parasympathetic nerve fibers (P<0.001) per unit area of PLX-II.

Conclusion: The patterns of extrapancreatic neuropathy could reflect the biological behavior of resectable pancreatic head adenocarcinoma, and the pathological features of PLX-II were closely related to early liver metastasis and mortality.

Keywords: extrapancreatic neuropathy; liver metastasis; neural remodeling; pancreatic adenocarcinoma.

Grants and funding

This study was supported by a grant from the Capital Characteristic Clinical Application Research and Achievement Promotion Project (No. Z171100001017121).