Aishima Shin-Ichi, Taguchi Ken-Ichi, Terashi Takahiro, Matsuura Shuji, Shimada Mitsuo, Tsuneyoshi Masazumi
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Mod Pathol. 2003 Oct;16(10):1019-27. doi: 10.1097/01.MP.0000086860.65672.73.
Tenascin and decorin are components of the extracellular matrix (ECM) that are implicated in cell proliferation in tumors. Here, we propose that abnormal expression of stromal ECM may play an important role in the progression of intrahepatic cholangiocarcinoma, which is characterized by desmoplastic reaction. To explore this hypothesis, we performed immunohistochemical analysis in order to examine the expression and distribution of tenascin and decorin in 75 cases of intrahepatic cholangiocarcinoma. In the intratumoral stroma, positive staining for tenascin was observed in 51 (68%) cases, and positive staining for decorin was observed in 61 (81%) cases. However, at the invasive front, positive staining for tenascin was found in 23 (31%) cases, and positive staining for decorin was found in 6 (8%) cases. Decorin staining was not correlated with aggressive behavior of intrahepatic cholangiocarcinoma, whereas intratumoral tenascin staining was correlated with lymphatic permeation and proliferative activity measured by Ki67. Tenascin staining at the invasive front was associated with tumor size, lymphatic permeation, lymph node metastasis, and proliferative activity and appeared to be a useful prognostic factor by univariate analysis, although it was not an independent prognostic factor. These results indicate that tenascin plays a role in tumor progression in cases of intrahepatic cholangiocarcinoma and that tenascin expression, especially at the invasive front, may be a useful marker in evaluating an unfavorable prognosis in patients with intrahepatic cholangiocarcinoma.
腱糖蛋白和核心蛋白聚糖是细胞外基质（ECM）的组成成分，与肿瘤细胞增殖有关。在此，我们提出，基质ECM的异常表达可能在以促结缔组织增生性反应为特征的肝内胆管癌进展中起重要作用。为了探究这一假说，我们进行了免疫组化分析，以检测75例肝内胆管癌中腱糖蛋白和核心蛋白聚糖的表达及分布情况。在肿瘤内基质中，51例（68%）观察到腱糖蛋白阳性染色，61例（81%）观察到核心蛋白聚糖阳性染色。然而，在浸润前沿，23例（31%）发现腱糖蛋白阳性染色，6例（8%）发现核心蛋白聚糖阳性染色。核心蛋白聚糖染色与肝内胆管癌的侵袭性行为无关，而肿瘤内腱糖蛋白染色与通过Ki67检测的淋巴渗透和增殖活性相关。浸润前沿的腱糖蛋白染色与肿瘤大小、淋巴渗透、淋巴结转移及增殖活性相关，单因素分析显示其似乎是一个有用的预后因素，尽管它不是一个独立的预后因素。这些结果表明，腱糖蛋白在肝内胆管癌病例的肿瘤进展中起作用，腱糖蛋白表达，尤其是在浸润前沿的表达，可能是评估肝内胆管癌患者不良预后的一个有用标志物。
