Impact of CD36 on Chemoresistance in Pancreatic Ductal Adenocarcinoma

  • Masahiko Kubo
  • Kunihito Gotoh
  • Hidetoshi EguchiEmail author
  • Shogo Kobayashi
  • Yoshifumi Iwagami
  • Yoshito Tomimaru
  • Hirofumi Akita
  • Tadafumi Asaoka
  • Takehiro Noda
  • Yutaka Takeda
  • Masahiro Tanemura
  • Masaki Mori
  • Yuichiro Doki
Translational Research and Biomarkers



CD36, a multi-ligand scavenger receptor, has been associated with several cancers. Many studies have revealed that CD36 contributed to cancer malignancy. This study aimed to reveal the function of CD36 expression in pancreatic ductal adenocarcinoma (PDAC).


CD36 expression was characterized using immunohistochemistry in 95 clinical specimens resected from patients with PDAC. We divided patients into two groups, with different CD36 expression levels, and analyzed and compared their prognoses. CD36 expression was also assessed in PDAC cell lines. Gemcitabine-resistant (GR) PDAC cell lines were transfected with small interfering RNA (siRNA) that specifically targeted CD36 to evaluate chemoresistance and apoptosis.


In resected PDAC samples, CD36 expression was significantly correlated with microinvasion into the venous system (p = 0.0284). Patients with high CD36 expression had significantly lower overall survival (OS) and recurrence-free survival (RFS) rates than patients with low expression; thus, CD36 was an independent prognostic factor for OS and RFS. In subgroup analyses, CD36 was an independent risk factor for OS and RFS in 59 patients treated with gemcitabine adjuvant chemotherapy. CD36 expression was upregulated in PDAC–GR cell lines compared with the PDAC parent cell line. Transduction with siRNA downregulated CD36, which reduced PDAC cell resistance to gemcitabine and inhibited anti-apoptosis proteins.


CD36 expression influenced gemcitabine resistance by regulating anti-apoptosis proteins. High CD36 expression was a significant, unfavorable prognostic factor in PDAC. Anti-CD36 treatment might serve as an optional treatment for lowering resistance to gemcitabine.



The authors would like to thank San Francisco Edit ( for the English language review.

Author Contributions

MK, KG, HE, SK, MM, and YD conceived and designed this study. KG and SK graded the expression of CD36. YI, YT, HA, TA, and TN acquired the data. MK, KG, HE, SK, YT, MT, MM, and YD drafted the manuscript. All authors read and approved the final version submitted for publication.


No funding was received for this study.


Masahiko Kubo, Kunihito Gotoh, Hidetoshi Eguchi, Shogo Kobayashi, Yoshifumi Iwagami, Yoshito Tomimaru, Hirofumi Akita, Tadafumi Asaoka, Takehiro Noda, Yutaka Takeda, Masahiro Tanemura, Masaki Mori, and Yuichiro Doki have declared no conflicts of interest.

Ethics Approval and Consent to Participate

Not applicable for this retrospective study.

Consent for Publication

Not applicable for this retrospective study.

Supplementary material

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Masahiko Kubo
    • 1
  • Kunihito Gotoh
    • 1
  • Hidetoshi Eguchi
    • 1
    Email author
  • Shogo Kobayashi
    • 1
  • Yoshifumi Iwagami
    • 1
  • Yoshito Tomimaru
    • 1
  • Hirofumi Akita
    • 1
  • Tadafumi Asaoka
    • 1
  • Takehiro Noda
    • 1
  • Yutaka Takeda
    • 1
    • 2
  • Masahiro Tanemura
    • 1
    • 3
  • Masaki Mori
    • 1
    • 4
  • Yuichiro Doki
    • 1
  1. 1.Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University HospitalOsaka UniversitySuitaJapan
  2. 2.Department of SurgeryKansai Rosai HospitalHyogoJapan
  3. 3.Department of SurgeryRinku General Medical CenterOsakaJapan
  4. 4.Department of Surgery and Science, Graduate School of MedicineKyushu UniversityFukuokaJapan

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