PERINEURAL INVASION BY DUCTAL ADENOCARCINOMA OF THE PANCREAS

Background and Objectives: The correlation between various levels of p erineural invasion by pancreatic carcinoma and the patient's prognosis has never been cleared, The authors carried out a histopathologic stu dy of resected pancreatic carcinoma to elucidate the significance of a new histologic finding concerning perineural invasion, which we desig nated ''intrapancreatic, extratumoral perineural invasion (nex),'' and also to determine its predictive value for prognoses of patients afte r surgical removal of the tumor. Methods: We investigated 90 patients with pancreatic adenocarcinoma who had under undergone pancreatic rese ction. the prognoses of all patients were explored, and correlations b etween survival and pathologic factors were statistically examined for neural invasion. Results: Nex was found in more than 50% of resected pancreases, A statistically significant association was found between the presence of nex and the grade of intrapancreatic neural invasion o r the presence of extrapancreatic neural plexus invasion. Nex was also found to be associated with patient survival after removal of the tum or. Conclusions: Nex appears to be an element predicting pancreatic ca ncer infiltration to the extrapancreatic nerve plexus and also to be a factor influencing postoperative survival of patients with pancreatic carcinoma. (C) 1997 Wiley-Liss, Inc.