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Figure 1.

Characterization of stromal CD271 expression in pancreatic cancer.

(A) Immunohistochemical staining for CD271 in pancreatic tissues. (A-a) In normal pancreas (NP), stromal cells rarely stain positive for CD271. (A-b, -c) Stromal cells are strongly stained around pancreatic intraepithelial neoplasia (PanIN) (b) and intraductal papillary mucinous neoplasm (IPMN) (c). (A-d) In pancreatic ductal adenocarcinomas (PDAC), stromal cells are partly stained, and CD271+ stromal cells are not adjacent to pancreatic cancer cells. Black arrowheads and arrows indicate CD271+ cells and nerves as positive control in the serial sections. (A-e) α-smooth muscle actin (SMA) is expressed most stromal cells around cancer cells and neoplastic tubules. White arrowheads indicate α-SMA cells in the serial sections. Original magnification: 200×, insets: 600×. (B) Kaplan–Meier survival analysis for CD271 high expression in the stroma of PDAC. Stromal CD271 high expression is associated with a good prognosis (p = 0.0040).

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Table 1.

Stromal CD271 high staining rates in surgical pancreatic tissues.

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Table 2.

Relationships between stromal CD271 expression and clinicopathologic factors.

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Table 3.

Multivariate survival analysis (Cox regression model) of conventional prognostic factors and stromal CD271 expression.

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Figure 2.

Analyses of CD271 expression in human pancreatic stellate cells (PSCs) isolated from pancreatic tissues.

(A) Representative microphotograph of immunofluorescence staining for α-smooth muscle actin (SMA) (green) and vimentin (red) in PSCs. Nuclei were counterstained with 4′,6-diamidino-2-phenylindole (blue). PSCs show a stellate-like or spindle-shaped morphology and express α-SMA. Original magnification: 200×. (B) The positive rates of CD271 expression in PSCs are 0.0–2.1% by flow cytometric analyses. Representative flow cytometric images of CD271 in activated PSCs are also shown (right).

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Figure 3.

CD271+ pancreatic stellate cells (PSCs) are increased through cancer–stroma interactions.

(A) In flow cytometry analyses, the percentage of CD271+ cells is higher in coculture than in monoculture (0.7–0.8% vs. 0.1%). (B) The levels of CD271 mRNA expression in two cultures of PSCs are significantly higher in cocultures with pancreatic cancer cells than in monocultures (p<0.001). (C) The level of CD271 mRNA expression is higher in cultures with a cancer cell-derived supernatant than in monocultures (p = 0.0053). (D) Representative microphotograph of immunofluorescence staining for CD271 (green) and α-smooth muscle actin (SMA) (red) in PSCs. Nuclei were counterstained with 4′,6-diamidino-2-phenylindole (blue). CD271 in PSCs was slightly expressed in cultures with cancer cell-derived supernatant, although it was difficult to detect CD271 expression in monocultures. Original magnification: 200×. *p<0.01; **p<0.001.

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Figure 4.

CD271 expression in pancreatic stellate cells (PSCs) decreases after long-term interactions with pancreatic cancer cells.

(A) Real-time qRT-PCR analyses showed that the levels of CD271 mRNA expression in PSCs in coculture with pancreatic cancer cells start to increase on day 3 (p = 0.0249), are highest on day 4 (p<0.0001), and then decrease the following day after the peak expression (p<0.0001). (B) In cultures with addition of cancer cell-derived supernatant, the level of CD271 mRNA expression started to increase at day 2 (p<0.0001) and then decreased on day 4 (p<0.0001). (C) Evaluation of the differences in CD271 expression depending on the function of PSCs by real-time qRT-PCR. The level of CD271 mRNA expression in top side-derived PSCs, which did not move toward cancer cells through Matrigel and remained on upper chambers, is lower than that in bottom side-derived PSCs, which did move toward pancreatic cancer cells through Matrigel (p<0.01). *p<0.05; **p<0.01; ***p<0.001; NS, not significant.

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Figure 5.

Expression of α-smooth muscle actin (SMA)+ and CD271+ stromal cells during in vivo tumor growth of pancreatic cancer.

(A) α-SMA+ stromal cells, as activated PSCs, exist in the xenograft tumor and normal pancreas (NP) areas (left side) around the tumor (right side). (B) Few CD271+ stromal cells were present in the NP area (left side) around the xenograft tumor, and were absent in the tumor core (right side). Original magnification: 200×.

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