Takagi Kosei, Noma Kazuhiro, Nagai Yasuo, Kikuchi Satoru, Umeda Yuzo, Yoshida Ryuichi, Fuji Tomokazu, Yasui Kazuya, Tanaka Takehiro, Kashima Hajime, Yagi Takahito, Fujiwara Toshiyoshi
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
Front Oncol. 2023 Mar 16;13:1072106. doi: 10.3389/fonc.2023.1072106. eCollection 2023.
Cancer-associated fibroblasts (CAFs) reportedly enhance the progression of gastrointestinal surgery; however, the role of CAFs in ampullary carcinomas remains poorly examined. This study aimed to investigate the effect of CAFs on the survival of patients with ampullary carcinoma.
A retrospective analysis of 67 patients who underwent pancreatoduodenectomy between January 2000 and December 2021 was performed. CAFs were defined as spindle-shaped cells that expressed α-smooth muscle actin (α-SMA) and fibroblast activation protein (FAP). The impact of CAFs on survival, including recurrence-free (RFS) and disease-specific survival (DSS), as well as prognostic factors associated with survival, was analyzed.
The high-α-SMA group had significantly worse 5-year RFS (47.6% vs. 82.2%, p = 0.003) and 5-year DSS (67.5% vs. 93.3%, p = 0.01) than the low-α-SMA group. RFS (p = 0.04) and DSS (p = 0.02) in the high-FAP group were significantly worse than those in the low-FAP group. Multivariable analyses found that high α-SMA expression was an independent predictor of RFS [hazard ratio (HR): 3.68; 95% confidence intervals (CI): 1.21-12.4; p = 0.02] and DSS (HR: 8.54; 95% CI: 1.21-170; p = 0.03).
CAFs, particularly α-SMA, can be useful predictors of survival in patients undergoing radical resection for ampullary carcinomas.
据报道，癌症相关成纤维细胞（CAFs）可促进胃肠道手术进展；然而，CAFs在壶腹癌中的作用仍未得到充分研究。本研究旨在探讨CAFs对壶腹癌患者生存的影响。
对2000年1月至2021年12月期间接受胰十二指肠切除术的67例患者进行回顾性分析。CAFs定义为表达α平滑肌肌动蛋白（α-SMA）和成纤维细胞活化蛋白（FAP）的梭形细胞。分析CAFs对生存的影响，包括无复发生存期（RFS）和疾病特异性生存期（DSS），以及与生存相关的预后因素。
高α-SMA组的5年RFS（47.6%对82.2%，p = 0.003）和5年DSS（67.5%对93.3%，p = 0.01）明显低于低α-SMA组。高FAP组的RFS（p = 0.04）和DSS（p = 0.02）明显低于低FAP组。多变量分析发现，高α-SMA表达是RFS[风险比（HR）：3.68；95%置信区间（CI）：1.21 - 12.4；p = 0.02]和DSS（HR：8.54；95% CI：1.21 - 170；p = 0.03）的独立预测因素。
CAFs，尤其是α-SMA，可作为壶腹癌根治性切除患者生存的有用预测指标。
