الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
SMAD4 and HER2 are currently considered as prognostic markers and therapeutic targets in many human cancers. Aim of the Work: This study aims to evaluate mmunohistochemical (IHC) expression of SMAD4 in pancreatic ductal adenocarcinoma (PDAC) and explore its prognostic role in terms of association with HER2 expression, different clinico-pathological variables and with patients’ disease-free and overall survival (DFS, OS). Material and Methods: This is a retrospective study including 83 cases of PDAC resection cases that were diagnosed from 2014 to 2019 at the pathology lab at Gastrointestinal Surgery Centre (GISC), Mansoura University. After demographic, clinicopathological and survival data collection, histopathological evaluation was done for PDAC assessment of the histopathological prognostic parameters. IHC was performed for SMAD4, HER2. Results: SMAD4 was positive in 48.2% of cases (40 cases) and had abnormal expression (negative) in 51.8% of cases (43 cases). There was a statistically significant relationship between SMAD4 expression and the following: tumor site, the pancreatic safety margin (PS) infiltration, presence LVI and tumor size. There was a statistically significant relationship between HER2 expression and the presence of LVI and TNM stage. Patients with negative SMAD4 expression had higher percentage of both death and relapse than those with retained SMAD4 expression, but with no significant statistical relationship. Conclusion: The utility of IHC to assess SMAD4 and HER2 in PDACs could be of prognostic and therapeutic importance. SMAD4 loss and HER2 overexpression are associated with bad prognosis.