Objectives: The aim of this study was to determine the clinicopathological significance of blood group expression patterns in patients with surgically resected pancreatic ductal adenocarcinomas. Methods: Pancreatic ductal adenocarcinomas from 459 patients were analyzed for immunohistochemical expression of A and B blood group antigens on tissue microarrays. Correlations were established by Fisher’s test, χ2 test, and logistic regression models, and relationships to postsurgical overall survival were analyzed by Kaplan-Meier method, log-rank test, and multivariate Cox models. Results: Tumors expressing blood group A antigen predicted fewer lymph node metastases (<3) and had longer postoperative survival by univariate and multivariate analysis. Loss of A antigen tumor expression in A blood group type patients correlated to vascular invasion. Conclusion: In patients with resectable pancreatic ductal adenocarcinomas, blood group A antigen expression predicted fewer lymph node metastases and was associated with improved outcome after pancreaticoduodenectomy.

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