Prognostic Impact of Cathepsin D Expression in Pancreatic Cancer– A Study of 50 Cases.

Revathishree, R (2013) Prognostic Impact of Cathepsin D Expression in Pancreatic Cancer– A Study of 50 Cases. Masters thesis, Stanley Medical College, Chennai.


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One Of The Leading Causes Of Mortality In Case Of Malignancies Is Carcinoma Of The Pancreas. Worldwide, In Death Due To Malignancies , Adenocarcinoma Of The Pancreas , Has The Overall Five Year Survival Rate Of 3% . In India, The Pancreatic Cancer Incidence Is 1 To 2.5 / 1 Lakh Men. In The United States It Is The Fifth Leading Cause Of Death. Most Of The Cases Presents In Advanced Stage Because Of Subtle Clinical Manifestation. The Percentage Of Those Patients Presenting With A Resectable Tumor Is Only 13 -22 % [1] . With A Curative Resection The Five Year Survival Rate Reaches To 25-30%. [2,3,4 ]. The Causes For The Poor Prognosis Of The Tumor Is Attributed To: Subtle Clinical Presentation. Invasion Of The Adjacent Blood Vessels-Hematogenous Metastasis [5] Neovascularization [6 ] High Micro Vessel Density (MVD) Of The Tumor [7] Angiogenesis Promoting Factor – Vascular Epidermal Growth Factor (VEGF) [8] Besides Angiogenesis, The Local Invasion Of The Tumor Cells Through Detachment From The Primary Lesion Is Another Important Critical Step In Tumor Progression And Metastasis. Local Tumor Invasion And Metastasis Is Also Caused By The Family Of Lysosomal Cysteine Proteases Namely The Cathepsins. These Proteases Plays Critical Role In Distinct Tumorigenic Processes Such As Proliferation, Angiogenesis, Apoptosis And Invasion Into Adjacent Organs And Metastasis . They Degrade The Extracellular Matrix And Give Neovascularization And Tumor Cell Migration Space [ 9,10,11 ] In Case Of Solid Tumors , Local Tumor Invasion Has Been Promoted By Lysosomal Proteases Cathepsin Enzymes. Of Which Highly Expressed Cathepsin Plays Critical Role In Invasion And Metastases Of Pancreatic Adenocarcinoma [12 ]. In A Multi Variate Analysis, Curative Resection I.E No Residual Tumor (Ro) Was The Only Clinical Parameter Related To Favourable Prognosis. Some Cases Have Poor Outcome Despite Curative Resection [13] . In Recent Years, The Expression Of Various Factors Like MVD, VEGF And Cathepsins Were Assessed Using Biological Markers In Terms Of Prognostic Evaluation In Pancreatic Adenocarcinoma. Studies Have Shown That After Curative Resection Numerous Predictor Factors UICC Stage, , Tumor Grading And TNM Classification For Survival , But Cathepsin Is Believed To Be Essential Predictor For Early Tumor Recurrence [14,15]. When Compared To Other Organ Tumors , Pancreatic Cancer Has Poor Prognosis. When All Stages Are Combined Together : 5-Year Relative Survival Rates Is Approximately 6%. 1 Year Survival Rate Is 22 – 26 %. The 5-Year Survival Rate Is Approximately 20% For Local Disease [16] . In Terms Of Months, The Median Survival Rate: For Locally Advanced Disease Is 10 -12 Months For Metastatic Disease, It Is About 6 - 8months Respectively [17,18]. This Study Focuses At Assessing The Correlation Between The Lysosomal Proteases Cathepsin D And Pancreatic Adenocarcinoma Grade, Perineural And Lymphovascular Invasion , Serum Carbohydrate Antigen 19.9 Level In Terms Of Prognosis. And Thereby Studying The Histopathology Of Lesions With A Note On Incidence Of The Tumor During The Study Period.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Prognostic Impact ; Cathepsin D ; Expression ; Pancreatic Cancer – Case study.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 27 Jun 2017 11:42
Last Modified: 27 Jun 2017 11:42

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