Intranuclear accumulation of galectin-3 is associated with a poor prognosis in patients with invasive intraductal papillary mucinous neoplasm

Abstract

Background: Although intraductal papillary mucinous neoplasms (IPMNs) have become recognized as the most common cystic tumors of the pancreas, evaluations of the prognostic factors of invasive IPMN have not yet been firmly established. Furthermore, the significance of galectin-3 expression in the prognosis of IPMN has not yet examined. Materials and Methods: We retrospectively examined galectin-3 expression immunohistochemically in 53 patients with IPMNs who underwent resection: 28 patients with non-invasive IPMN (including 3 patients with IPMN with carcinoma in situ component), and 25 patients with invasive IPMN. Results: The intranuclear accumulation of galectin-3 (gal-3-INA) was more frequently encountered in patients with invasive IPMN than with non-invasive IPMN (P = 0.038). Incidences of background fibrosis and dilatation of the main pancreatic duct were higher in the high-galectin-3 expression group than in the low-galectin-3 expression group (P = 0.0041 and 0.006, respectively). Incidence of background fibrosis was also higher in patients with gal-3-INA than without gal-3-INA (P = 0.011). The presence of gal-3-INA was higher in the high-galectin-3 expression group than in the low-galectin-3 expression group (P = 0.014). The high-galectin-3- expression group and the patients with gal-3-INA had a significantly poorer prognosis than the low-galectin-3-expression group and those without gal-3-INA (P = 0.020 and P = 0.014, respectively). Multivariate analysis using a Cox regression model revealed that gal-3-INA was an independent prognostic factor (hazard ratio: 5.162, 95% confidential interval: 1.033-25.807, P = 0.046). Conclusions: The presence of gal-3-INA is an independent prognostic factor for patients with invasive IPMN.