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      Elevated glypican‐1 expression is associated with an unfavorable prognosis in pancreatic ductal adenocarcinoma

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          Abstract

          Pancreatic ductal adenocarcinoma (PDAC) is the most lethal cancer in humans, with a 5‐year survival rate of <5%. Recently, glypican‐1 (GPC1)‐expressing circulating exosomes were found to be a promising diagnostic tool for PDAC. However, the aberrant expression of GPC1 has not been systematically evaluated in large‐scale clinical samples of PDAC. Here, we performed a comprehensive analysis of GPC1 mRNA and protein expression features. Included in this study were 178 PDAC patients from the cancer genome atlas (TCGA) and 186 subjects whose tissues were used in immunohistochemical staining assays. We demonstrated that GPC1 mRNA was silenced in normal pancreata; however, it was re‐expressed in PDAC tissues probably because of the promoter hypomethylation. The GPC1 protein was barely expressed in the normal and adjacent noncancerous pancreata. In tumor tissues, 59.7% (111/186) of the detected samples showed positive expression. Notably, GPC1 was elevated in 63.6% (34/55) of early stage cases. High levels of GPC1 were associated with poorer differentiation and larger tumor diameters. Kaplan–Meier analysis showed a significant difference in overall survival between the groups categorized by GPC1 expression ( P = 0.0028). Multivariate analyses indicated that GPC1 was a significant risk factor for poor overall survival with a 1.82‐fold increase in the hazard ratio ( P = 0.0022). In conclusion, during pancreatic tumorigenesis, GPC1 was ectopically expressed and served as an independent poor prognostic factor. Our findings highlighted the alluring prospect of GPC1 as an early diagnostic and prognostic marker as well as a therapeutic target for PDAC.

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          Most cited references25

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          Shear-induced endothelial NOS activation and remodeling via heparan sulfate, glypican-1, and syndecan-1.

          Mammalian epithelial cells are coated with a multifunctional surface glycocalyx (GCX). On vascular endothelial cells (EC), intact GCX is atheroprotective. It is degraded in many vascular diseases. GCX heparan sulfate (HS) is essential for healthy flow-induced EC nitric oxide (NO) release, elongation, and alignment. The HS core protein mechanisms involved in these processes are unknown. We hypothesized that the glypican-1 (GPC1) HS core protein mediates flow-induced EC NO synthase (eNOS) activation because GPC1 is anchored to caveolae where eNOS resides. We also hypothesized that the HS core protein syndecan-1 (SDC1) mediates flow-induced EC elongation and alignment because SDC1 is linked to the cytoskeleton which impacts cell shape. We tested our hypotheses by exposing EC monolayers treated with HS degrading heparinase III (HepIII), and monolayers with RNA-silenced GPC1, or SDC1, to 3 to 24 hours of physiological shear stress. Shear-conditioned EC with intact GCX exhibited characteristic eNOS activation in short-term flow conditions. After long-term exposure, EC with intact GCX were elongated and aligned in the direction of flow. HS removal and GPC1 inhibition, not SDC1 reduction, blocked shear-induced eNOS activation. EC remodeling in response to flow was attenuated by HS degradation and in the absence of SDC1, but preserved with GPC1 knockdown. These findings clearly demonstrate that HS is involved in both centralized and decentralized GCX-mediated mechanotransduction mechanisms, with GPC1 acting as a centralized mechanotransmission agent and SDC1 functioning in decentralized mechanotransmission. This foundational work demonstrates how EC can transform fluid shear forces into diverse biomolecular and biomechanical responses.
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            Carbohydrate Antigen 19-9 Elevation in Anatomically Resectable, Early Stage Pancreatic Cancer Is Independently Associated with Decreased Overall Survival and an Indication for Neoadjuvant Therapy: A National Cancer Database Study.

            Patient triage in anatomically resectable, early stage pancreatic ductal adenocarcinoma (PDAC) with elevated carbohydrate antigen 19-9 (CA 19-9) remains unclear. We hypothesized that any CA 19-9 elevation indicates biologically borderline resectability.
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              Deciphering the role of stroma in pancreatic cancer.

              This review intends to describe recent studies on pancreatic tumor-associated stroma and potential opportunities and limitations to its targeting. One of the defining features of pancreatic cancer is extensive desmoplasia, or an inflammatory, fibrotic reaction. Carcinoma cells live in this complex microenvironment which is comprised of extracellular matrix (ECM), diffusible growth factors, cytokines and a variety of nonepithelial cell types including endothelial cells, immune cells, fibroblasts, myofibroblasts and stellate cells. In addition to the heterogeneity noted in the nonneoplastic cells within the tumor microenvironment, it has also been recognized that neoplastic cancer cells themselves are heterogeneous, and include a subpopulation of stem-cell like cells within tumors termed cancer stem cells. Due to the failure of current therapeutics to improve outcomes in patients with pancreatic cancer, new therapeutic avenues targeting different components of the tumor microenvironment are being investigated. In this review article, we will focus on recent studies regarding the function of the tumor stroma in pancreatic cancer and therapeutic treatments that are being advanced to target the stroma as a critical part of tumor management. Recent studies have shed new light on the contribution of the pancreatic cancer fibroinflammatory stroma to pancreatic cancer biology. Additional studies are needed to better define its full contribution to tumor behavior and how to best understand the optimal ways to develop therapies that counteract its pro-neoplastic properties.
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                Author and article information

                Contributors
                ylsun@cicams.ac.cn
                zhaoxh@cicams.ac.cn
                Journal
                Cancer Med
                Cancer Med
                10.1002/(ISSN)2045-7634
                CAM4
                Cancer Medicine
                John Wiley and Sons Inc. (Hoboken )
                2045-7634
                24 April 2017
                June 2017
                : 6
                : 6 ( doiID: 10.1002/cam4.2017.6.issue-6 )
                : 1181-1191
                Affiliations
                [ 1 ] Department of PathologyNational Cancer Center/Cancer Hospital Chinese Academy of Medical Science & Peking Union Medical College Beijing 100021China
                [ 2 ] State Key Laboratory of Molecular OncologyNational Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100021China
                Author notes
                [*] [* ] Correspondence

                Xiaohang Zhao and Yulin Sun, State Key Laboratory of Molecular Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, 17 Panjiayuan Nanli, Chaoyang, Beijing 100021, China. Tel: +86 10 67709015(XZ), +86 10 87788423(YS); Fax: +86 10 87778360, E‐mails: zhaoxh@ 123456cicams.ac.cn , ylsun@ 123456cicams.ac.cn

                [†]

                These authors contributed equally.

                Author information
                http://orcid.org/0000-0003-3668-2712
                Article
                CAM41064
                10.1002/cam4.1064
                5463070
                28440066
                082bcf8b-0b2a-4230-9e72-957fcc8aa910
                © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 February 2017
                : 28 February 2017
                : 05 March 2017
                Page count
                Figures: 4, Tables: 2, Pages: 11, Words: 5669
                Funding
                Funded by: National Natural Science Foundation of China
                Award ID: 81572840
                Award ID: 81572365
                Award ID: 81372591
                Award ID: 91629105
                Funded by: State Key Project for Basic Research of China
                Award ID: 2014CBA02001
                Award ID: 2014CBA02002
                Funded by: Innovation Program of the Chinese Academy of Medical Sciences
                Award ID: 2016‐I2M‐1‐001
                Categories
                Original Research
                Clinical Cancer Research
                Original Research
                Custom metadata
                2.0
                cam41064
                June 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.1 mode:remove_FC converted:08.06.2017

                Oncology & Radiotherapy
                biomarker,gene expression,glypican‐1,pancreatic ductal adenocarcinoma,prognostic factor

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