الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 148 |  |  |
| | | from | 148 | | |
Abstract
Pancreatic cancer is the 11th most common malignant neoplasm world wide. The mortality rate for patients with pancreatic ductal adenocarcinoma (PDAC) is nearly 75% within one year of diagnosis, with the 5-year survival rate being less than 6% as more than 80% of PDAC patients are diagnosed at an already regional or distant metastasized stage. The only curative therapeutic option is radical surgery which offers long-term survival but it is only applicable in early tumor stages.
This highlights the need for discovery of new prognostic markers and diagnostic modalities to allow for better management of pancreatic ductal adenocarcinoma patients. With recent advancements in research that focus on tumor biology and behavior, a direct association between vitamin D and cancer risk was suggested.
The active form of vitamin D (calcitriol) binds to VDR, and translocates to nucleus to activate VDRE, which activates transcription of numerous genes involved in a myriad of cellular functions and processes. Impaired vitamin D activities have been widely implicated in human cancer.
In the present study, we analyzed the immunohistochemical expression of VDR in pancreatic ductal adenocarcinomas and correlated this expression with other clinicopathological parameters.
The present study comprised 50 Egyptian patients with histologically proven pancreatic ductal adenocarcinoma (16 cases of well differentiated PDAC, and 34 cases of moderately differentiated PDAC). The age of the cases ranged from 34 and 76 years with mean age of 55.82 ± 9.06 years and male to female ratio of 1.63:1. In addition, thirty normal pancreatic/chronic pancreatitis tissue were included as a control group.
Expression of VDR in the studied cases was predominantly nuclear. VDR immunohistochemical expression was quantified both semitiquantitavely using an IRS that was obtained by multiplying staining intensity and density and for statistical purposes, the VDR IRS was categorized as either positive IRS (2-12) or negative IRS (0-1). Moreover, quantitative assessment of VDR was also performed using a computer –assisted image analysis.
In the present study, no statistically significant correlation was found between patient’s age and VDR IRS (p 0.436) and also between patient’s sex and VDR IRS (p 0.055).
In the current study, VDR IRS was positive in 62.95% (22/35) of pT1, 61.55% (8/13) of pT2 and both cases (2/2) of pT3 tumors and therefore, the tumor size (pT) did not show a statistically significant correlation with both VDR IRS (p= 0.862) or mean cell count (p=0.739).
Semiquantitative assessment of VDR IHC expression among our studied PDAC cases revealed notable upregulation of expression with higher tumor grade as positive VDR IRS was noted in 50% (8/16) of well differentiated PDAC and 70.6% (24/34) of moderately differentiated PDAC. However, statistical significance was not reached. Conversely, quantitative assessment of VDR expression using mean cell count obtained by image analysis highlighted the presence of a statistically significant between the VDR mean cell count and tumor grade (p=<0.001).