{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:30:06Z","timestamp":1793089806967,"version":"4.5.0"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Aims:<\/jats:title>\n                    <jats:p>Pancreatic ductal adenocarcinoma is an aggressive neoplasm with poor prognosis. The metabolic properties of its desmoplastic stroma are hypothesized to contribute to disease progression. Aberrant metabolism in tumor cells and desmoplastic stroma results in the accumulation of metabolic by-products, with lactate being the most important, released into the extracellular space by monocarboxylate transporters (MCTs). This study aimed to determine the prognostic value of these markers and identify potential therapeutic targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design\/Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      Eighty-eight patients with Pancreatic adenocarcinomas (PDAC) were included. The tumoral and\/or stromal expression of\n                      <jats:italic toggle=\"yes\">MCT1<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">MCT4<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">SMAD4<\/jats:italic>\n                      , vimentin,\n                      <jats:italic toggle=\"yes\">Ki67<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">CD10<\/jats:italic>\n                      , and smooth muscle actin were investigated using the immunohistochemical analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\/Conclusions:<\/jats:title>\n                    <jats:p>\n                      High MCT1 expression in tumor tissue was an independent prognostic marker for overall survival (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01). Intense MCT1 expression in tumor tissue was associated with larger tumor size (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Vimentin positivity and a higher\n                      <jats:italic toggle=\"yes\">Ki67<\/jats:italic>\n                      proliferation index were observed in the patients with lymphovascular invasion (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05 and,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01, respectively).\n                      <jats:italic toggle=\"yes\">SMAD4<\/jats:italic>\n                      loss was higher in patients with metastasis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). The overall survival was significantly reduced when the\n                      <jats:italic toggle=\"yes\">Ki67<\/jats:italic>\n                      proliferation index exceeded 50% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01). In conclusion, overexpression of\n                      <jats:italic toggle=\"yes\">MCT1<\/jats:italic>\n                      , a high\n                      <jats:italic toggle=\"yes\">Ki67<\/jats:italic>\n                      proliferation index, and loss of\n                      <jats:italic toggle=\"yes\">SMAD4<\/jats:italic>\n                      expression may serve as prognostic indicators of poor outcomes in PDAC. These findings hold the potential to guide the development of more effective therapeutic strategies for treating PDAC.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijpm.ijpm_739_24","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T17:00:08Z","timestamp":1755536408000},"page":"723-729","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Comprehensive immunohistochemical analysis associated with the tumor microenvironment including monocarboxylate transporters in pancreatic ductal adenocarcinoma"],"prefix":"10.4103","volume":"68","author":[{"given":"Duygu","family":"Ak\u00e7a","sequence":"first","affiliation":[{"name":"Department of Pathology, Tekirda\u011f Dr. \u0130smail Fehmi Cumal\u0131o\u011flu City Hospital, Tekirda\u011f, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atike 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