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Potential of Proliferative Markers in Pancreatic Cancer Management: A Systematic Review Publisher



Salahiniri A1 ; Zarand P1 ; Mansouri N1 ; Rastgou P2 ; Yazdani O1 ; Esbati R1 ; Shojaeian F3 ; Jahanbin B4 ; Mohsenifar Z5 ; Aghdaei HA1 ; Ardalan FA6 ; Safavinaini SAA1
Authors
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Authors Affiliations
  1. 1. Research, Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
  3. 3. Sidney Kimmel Comprehensive Cancer Research Center, Johns Hopkins School of Medicine, Baltimore, MD, United States
  4. 4. Cancer Institute, Pathology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Pathology, Ayatollah Taleghani Educational Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Pathology and Laboratory Medicine Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Source: Health Science Reports Published:2025


Abstract

Background and Aims: Pancreatic cancer is an aggressive malignancy with poor prognosis and limited treatment options. Chemotherapy remains a primary therapeutic approach, but patient responses vary significantly, emphasizing the need for reliable biomarkers. This review explores the potential role of proliferative markers, including Ki-67, PCNA, Cyclin D1, and PHH3, as predictive and prognostic indicators in pancreatic cancer management, aiming to enhance personalized treatment strategies. Methods: We conducted a narrative review by searching Scopus, PubMed, and Google Scholar for studies focusing on Ki-67, PCNA, Cyclin D1, and PHH3 in relation to pancreatic cancer and chemotherapy. The literature was reviewed to evaluate the role of these markers in predicting chemotherapy response, tumor progression, and overall patient survival. Results: The review highlights the clinical significance of these markers. Ki-67 and PCNA are associated with cell proliferation, while Cyclin D1 regulates cell cycle progression and PHH3 is linked to mitotic activity. High expression levels of these markers often correlate with increased tumor aggressiveness and poorer patient outcomes. Moreover, they show promise in predicting chemotherapy response, which can inform tailored therapeutic strategies. However, challenges remain, including standardization of detection methods and determination of optimal cutoff values. Conclusion: Proliferative markers such as Ki-67, PCNA, Cyclin D1, and PHH3 hold potential as predictive and prognostic tools in pancreatic cancer management. Their integration into clinical practice could improve the accuracy of treatment decisions and enhance patient outcomes. Further research and validation are necessary to overcome existing challenges and optimize their application in personalized oncology. © 2025 The Author(s). Health Science Reports published by Wiley Periodicals LLC.
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