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Low expression of DDX5 is associated with poor prognosis in patients with pancreatic ductal adenocarcinoma
  1. Masashi Morimachi1,
  2. Kenichi Hirabayashi2,
  3. Yumi Takanashi2,
  4. Aya Kawanishi1,
  5. Tsubasa Saika3,
  6. Yumiko Ueyama3,
  7. Toshio Nakagohri4,
  8. Naoya Nakamura2,
  9. Hidekazu Suzuki1,
  10. Tatehiro Kagawa1
  1. 1Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
  2. 2Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
  3. 3Division of Diagnostic Pathology, Tokai University Hospital, Isehara, Kanagawa, Japan
  4. 4Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
  1. Correspondence to Dr Kenichi Hirabayashi, Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, Japan; kenichi.hirabayashi{at}


Aims Pancreatic ductal adenocarcinoma (PDAC) is one of the most fatal malignancies. Hence, there is a need for new markers and treatment strategies. P68/DEAD box protein 5 (DDX5) is an ATP-dependent RNA helicase of the DEAD box protein family. It is a prognostic marker for several cancers. In this study, we aimed to evaluate the expression and clinical relevance of DDX5 in PDAC.

Methods DDX5 expression in tissue microarray blocks containing 230 PDAC samples was examined using immunohistochemical analysis. DDX5 expression was considered high when more than 50% of the cells were stained and low when less than 50% of the cells were stained. We investigated the association between DDX5 expression and clinicopathological parameters, including patient survival.

Results The nuclei of normal pancreatic ducts, normal acinar cells and PDAC cells were stained positive for DDX5 although the intensity and distribution of DDX5 expression varied. Islet cells showed strong and diffuse staining of DDX5. DDX5 expression was low and high in 148 (64.3%) and 82 cases (35.7%), respectively. Low DDX5 expression was significantly associated with an advanced pT factor (pT2–pT3: tumour size,>20 mm), lymphatic involvement, advanced tumour-node-metastasis (TNM) stage (stages IIB, III, and IV), and venous involvement. In addition, the multivariate analysis revealed that DDX5 expression is an independent prognostic factor for PDAC.

Conclusion These results suggest that DDX5 plays an important role in tumour invasiveness and PDAC prognosis.

  • pathology
  • surgical
  • pancreas
  • pancreatic neoplasms
  • carcinoma
  • immunohistochemistry

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  • Handling editor Dhirendra Govender.

  • Contributors MM and KH conceived and designed the study, interpreted immunohistochemical staining results, performed the statistical analyses and wrote the manuscript. MM also performed immunohistochemistry, prepared tissue microarray blocks and summarised clinicopathological data. TS and YU prepared tissue microarray blocks and samples for immunohistochemistry. YT supported the immunohistochemistry analysis and reviewed the manuscript. AK summarised clinicopathological data. NN, HS and TK reviewed the manuscript.

  • Funding This work was supported by Tokai University School of Medicine Research-Aid Grant 2018 and JSPS KAKENHI (grant number 20K17034).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Clinical Research Committee of Tokai University (approval No. 17R275).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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