Zhou Hongbing, Yuan Yin, Qian Haixin
Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.
Department of Hepatobiliary Surgery, The Fifth Affiliated Hospital of The Medical School of Nantong University, Taizhou, Jiangsu 225300, P.R. China.
Exp Ther Med. 2021 Jul;22(1):738. doi: 10.3892/etm.2021.10170. Epub 2021 May 9.
Surgical treatment of gallbladder carcinoma remains challenging, while targeted therapy has been demonstrated to have potential. In the present study, the effect of signal transducer and activator of transcription 3 (STAT3) expression and vasculogenic mimicry (VM) on the occurrence and development of gallbladder carcinoma was evaluated. A total of 72 patients with gallbladder carcinoma and 10 patients with chronic cholecystitis were examined. Immunohistochemical staining was performed to determine the positive expression rates of STAT3. Periodic acid Schiff CD34 double staining was performed to detect VM in the gallbladder carcinoma group. STAT3 expression and VM in gallbladder carcinoma tissues was compared among patients with different clinical characteristics. In postoperative patients with gallbladder cancer, the relationship of the postoperative recurrence time with STAT3 expression and VM was assessed. STAT3 expression in gallbladder carcinoma tissue was significantly higher than that in cholecystitis tissue (P<0.05). STAT3 expression levels and VM were positively correlated in gallbladder carcinoma tissue. STAT3 protein expression in gallbladder carcinoma tissues differed significantly among patients with different degrees of differentiation and clinical stages (P<0.05). Among the 51 patients who completed the 3-year follow-up, the mean time to relapse was 17.353 and 35.647 months in those with high and low STAT3 expression, respectively, with significant differences (P<0.05). The VM structure was detected in 47 cases (92.15%) and not detected in four cases (7.84%), which exhibited no immediate recurrence after surgery, and the difference in the mean postoperative recurrence time was significant (22.38 vs. 36.00 months, respectively; P<0.05). In gallbladder carcinoma tissues, a lower degree of differentiation, higher malignancy degree and higher clinical stage were associated with higher expression of STAT3 and VM. Thus, STAT3 may promote VM formation in the process of tumor occurrence, development and metastasis. Therefore, STAT3 as a regulatory target, may inhibit the proliferation and invasion of tumor cells and block the development of VM, thereby representing a suitable target for antitumor angiogenesis therapy.
胆囊癌的手术治疗仍然具有挑战性，而靶向治疗已被证明具有潜力。在本研究中，评估了信号转导和转录激活因子3（STAT3）表达及血管生成拟态（VM）对胆囊癌发生发展的影响。共检查了72例胆囊癌患者和10例慢性胆囊炎患者。采用免疫组织化学染色法测定STAT3的阳性表达率。对胆囊癌组进行高碘酸希夫CD34双重染色以检测VM。比较不同临床特征患者胆囊癌组织中STAT3表达和VM情况。在胆囊癌术后患者中，评估术后复发时间与STAT3表达和VM的关系。胆囊癌组织中STAT3表达明显高于胆囊炎组织（P<0.05）。胆囊癌组织中STAT3表达水平与VM呈正相关。不同分化程度和临床分期的胆囊癌患者组织中STAT3蛋白表达差异有统计学意义（P<0.05）。在完成3年随访的51例患者中，STAT3高表达和低表达患者的平均复发时间分别为17.353个月和35.647个月，差异有统计学意义（P<0.05）。47例（92.15%）检测到VM结构，4例（7.84%）未检测到，这4例术后未立即复发，术后平均复发时间差异有统计学意义（分别为22.38个月和36.00个月；P<0.05）。在胆囊癌组织中，低分化程度、高恶性程度和高临床分期与STAT3和VM的高表达相关。因此，STAT3可能在肿瘤发生、发展和转移过程中促进VM形成。所以，STAT3作为一个调控靶点，可能抑制肿瘤细胞的增殖和侵袭，阻断VM的发展，从而成为抗肿瘤血管生成治疗的合适靶点。
