Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Dig Surg. 2013;30(4-6):309-16. doi: 10.1159/000354341. Epub 2013 Sep 4.
An increasing incidence of cholangiocarcinoma (CCA) and CCA mortality rates has been observed around the world. Patients with intrahepatic biliary stones have a 10% risk of developing CCA, and up to 70% of patients with histologically confirmed CCA have hepatolithiasis. Few previous studies have addressed the associations between the expression of nuclear factor (NF)-κB and epidermal growth factor receptor (EGFR) and clinicopathological prognosis in patients with hepatolithiasis-associated intrahepatic CCA.
This study was designed to investigate the clinicopathological and prognostic significance of NF-κB and EGFR expression in hepatolithiasis-associated intrahepatic CCA and hepatolithiasis.
A total of 90 liver specimens were immunohistochemically stained for NF-κB and EGFR expression, and the characteristics of 90 individual patients were retrospectively reviewed.
Differences in the positive rates of NF-κB and EGFR expression between the hepatolithiasis-associated intrahepatic CCA group, intrahepatic lithiasis group, and control group were found to be statistically significant. EGFR expression was closely associated with the degree of differentiation and depth of invasion (p < 0.05). The 1-, 3-, and 5-year overall survival rates were respectively 42.8, 21.0, and 10.3% in intrahepatic CCA groups. The survival rate of the EGFR-negative group was higher than in the EGFR-positive group (p < 0.01). Lymph node metastasis (HR 1.24, 95% CI 1.02-1.51) and EGFR positivity (HR 1.74, 95% CI 1.30-2.23) were associated with decreases in the survival rate.
The expression of NF-κB may be an early step in intrahepatic cholangiocarcinogenesis. Overexpression of EGFR is associated with the degree of malignancy and with poor prognosis. NF-κB and EGFR may cooperate during intrahepatic cholangiocarcinogenesis and progression. Lymph node metastasis and EGFR positivity were associated with decreases in the survival rate.
胆管癌（CCA）的发病率和死亡率在全球范围内呈上升趋势。肝内胆管结石患者发生 CCA 的风险为 10%，而组织学证实的 CCA 患者中有高达 70%患有胆石症。以前的研究很少涉及核因子（NF）-κB 和表皮生长因子受体（EGFR）的表达与胆石症相关的肝内 CCA 患者的临床病理预后之间的关系。
本研究旨在探讨 NF-κB 和 EGFR 表达在胆石症相关肝内 CCA 和胆石症中的临床病理和预后意义。
共对 90 例肝组织标本进行 NF-κB 和 EGFR 表达的免疫组织化学染色，并回顾性分析 90 例患者的特征。
发现胆石症相关肝内 CCA 组、肝内结石组和对照组 NF-κB 和 EGFR 表达的阳性率差异有统计学意义。EGFR 表达与分化程度和浸润深度密切相关（p<0.05）。肝内 CCA 组 1、3 和 5 年总生存率分别为 42.8%、21.0%和 10.3%。EGFR 阴性组的生存率高于 EGFR 阳性组（p<0.01）。淋巴结转移（HR 1.24，95%CI 1.02-1.51）和 EGFR 阳性（HR 1.74，95%CI 1.30-2.23）与生存率降低相关。
NF-κB 的表达可能是肝内胆管癌发生的早期步骤。EGFR 的过度表达与恶性程度有关，并与预后不良相关。NF-κB 和 EGFR 可能在肝内胆管癌的发生和进展中协同作用。淋巴结转移和 EGFR 阳性与生存率降低有关。
