ARC-Net Research Centre, University and Hospital Trust of Verona, Verona, Italy.
Department of Diagnostics and Public Health, Section of Anatomical Pathology, University and Hospital Trust of Verona, Verona, Italy.
Sci Rep. 2018 May 8;8(1):7119. doi: 10.1038/s41598-018-25669-1.
The incidence and mortality rates of intrahepatic cholangiocarcinoma have been rising worldwide. Few patients present an early-stage disease that is amenable to curative surgery and after resection, high recurrence rates persist. To identify new independent marker related to aggressive behaviour, two prognostic groups of patient were selected and divided according to prognostic performance. All patients alive at 36 months were included in good prognostic performers, while all patients died due to disease within 36 months in poor prognostic performers. Using high-coverage target sequencing we analysed principal genetic alterations in two groups and compared results to clinical data. In the 33 cases included in poor prognosis group, TP53 was most mutated gene (p = 0.011) and exclusively present in these cases. Similarly, ARID1A was exclusive of this group (p = 0.024). TP53 and ARID1A are mutually exclusive in this study. Statistical analysis showed mutations in TP53 and ARID1A genes and amplification of MET gene as independent predictors of poor prognosis (TP53, p = 0.0031, ARID1A, p = 0.0007, MET, p = 0.0003 in Cox analysis). LOH in PTEN was also identified as marker of disease recurrence (p = 0.04) in univariate analysis. This work improves our understanding of aggressiveness related to this tumour type and has identified novel prognostic markers of clinical outcome.
肝内胆管细胞癌的发病率和死亡率在全球范围内呈上升趋势。很少有患者表现出早期疾病,适合根治性手术,而且在切除后,高复发率仍然存在。为了确定与侵袭性行为相关的新的独立标志物,根据预后表现选择了两组预后患者,并进行了分组。所有在 36 个月时存活的患者均归入预后良好组,而所有在 36 个月内死于疾病的患者归入预后不良组。使用高覆盖靶向测序,我们分析了两组患者的主要遗传改变,并将结果与临床数据进行比较。在预后不良组的 33 例患者中,TP53 是突变频率最高的基因(p=0.011),且仅存在于这些患者中。同样,ARID1A 也仅存在于该组中(p=0.024)。在本研究中,TP53 和 ARID1A 是互斥的。统计分析显示,TP53 和 ARID1A 基因突变以及 MET 基因扩增是预后不良的独立预测因子(TP53,p=0.0031;ARID1A,p=0.0007;MET,p=0.0003,在 Cox 分析中)。PTEN 的 LOH 也被确定为疾病复发的标志物(p=0.04,在单因素分析中)。这项工作提高了我们对这种肿瘤类型侵袭性的理解,并确定了新的临床预后标志物。