Objective To determine the expression of monocarboxylate transporter 4 (MCT4) in pancreatic cancer tissue and its prognostic value after radical resection.

Methods The clinical data of 379 pancreatic cancer patients who underwent radical resection at Pancreatic Surgery of Fudan University Shanghai Cancer Center from February 2010 to June 2014 were retrospectively included in the study. The expression of MCT4 was tested with immunohistochemical staining and its relationship with clinicopathological characteristics of patients was investigated. Kaplan-Meier survival curve and multivariate Cox regression analysis were applied to evaluate the prognostic value of MCT4 expression.

Results Patients with positive expression of MCT4 protein were prone to have larger tumor size (P=0.004), greater lymph node metastasis (P=0.005), and higher TNM stage (P=0.011). The median overall survival (OS, 12.4 months) time and recurrence-free survival (RFS, 7.3 months) time of patients with positive expression of MCT4 were significantly shorter than those of patients with negative expression of MCT4 (21.3 months, P < 0.001; 11.4 months, P < 0.001). Multivariate Cox regression analysis results showed that the positive expression of MCT4 was an independent predictor of shorter OS (hazard ratio=1.814, 95% confidence interval 1.433-2.296, P < 0.001) and RFS (hazard ratio=1.648, 95% confidence interval 1.319-2.059, P < 0.001) in pancreatic cancer patients after radical resection.

Conclusions The positive expression of MCT4 is an independent prognostic factor for pancreatic cancer patients after radical resection, and might be a potential marker for the selection and treatment of patients with high recurrence risk.