Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
Department of Surgery, Kurume University School of Medicine, Kurume, Japan;
Anticancer Res. 2022 Aug;42(8):4079-4087. doi: 10.21873/anticanres.15905.
BACKGROUND/AIM: Surgical resection is the standard treatment for bile duct cancer. However, even when surgical resection is possible, the 5-year survival rate is reportedly 25.0-55.0%. Therefore, bile duct cancer is associated with poor prognoses. We conducted a clinicopathological investigation, focusing on the histological phenomenon of tumour budding, which has previously been reported to be correlated with the survival of patients with a variety of cancers.
To investigate the significance of tumour budding in distal bile duct cancer, we recruited 65 patients who underwent pancreatoduodenectomy at our institution between 1995 and 2011. Tumour budding was observed and evaluated using the 'hot spot method'. The 'low' budding group comprised 0-4 cell clusters and the 'high' budding group ≥5 cell clusters. Additionally, immunostaining was performed in high-budding areas.
Tumour budding and stage were confirmed using a Cox proportional hazards model as independent prognostic factors for overall survival (p<0.05) in all patients. There was a significant association between budding and zinc finger E-box binding homeobox 1 expression, an endothelial-mesenchymal transition-induced transcription factor. In stage II cases, the prognosis was significantly worse in the 'high' budding group compared to that in the 'low' budding group.
The budding phenomenon is an independent prognostic factor for patients with distal bile duct cancer. Understanding the mechanisms underlying tumour budding in distal bile duct cancer and its relationship with poor prognoses may be useful for the development of novel treatments for this disease.
背景/目的：手术切除是胆管癌的标准治疗方法。然而，即使手术切除可行，5 年生存率据报道仍为 25.0-55.0%。因此，胆管癌预后较差。我们进行了一项临床病理研究，重点关注肿瘤芽殖的组织学现象，该现象以前被报道与各种癌症患者的生存相关。
为了研究肿瘤芽殖在远端胆管癌中的意义，我们招募了 65 名在我院于 1995 年至 2011 年间接受胰十二指肠切除术的患者。使用“热点法”观察和评估肿瘤芽殖。“低”芽殖组包括 0-4 个细胞簇，“高”芽殖组≥5 个细胞簇。此外，在高芽殖区域进行免疫染色。
肿瘤芽殖和分期通过 Cox 比例风险模型被确认为所有患者总生存的独立预后因素（p<0.05）。芽殖与锌指 E 盒结合同源盒 1 表达（一种诱导内皮-间充质转化的转录因子）之间存在显著关联。在 II 期病例中，“高”芽殖组的预后明显差于“低”芽殖组。
芽殖现象是远端胆管癌患者的独立预后因素。了解远端胆管癌中肿瘤芽殖的发生机制及其与预后不良的关系，可能有助于为该疾病开发新的治疗方法。
