Retrospective Study On The Clinical Diagnosis And Treatment Of 134 Cases In Human Hilar Cholangiocarcinoma As Well As The Relationship Between The Ratio Of MMP-2/TIMP-2 Of 50 Cases

Tumors in the proximal third of the bile duct (hilar cholangiocarcinoma. ) are associated with the lowest rates of respectability and poorest survival of tumors in all locations in the bile duct. With the improvement of surgical treatment for hilar cholangiocarcinoma. , now the 5-year survival rate for the patients is obviously higher than before, however, the recurrence and metastasis of tumors is still a main problem faced by surgeons.Through a retrospective analysis of clinical data of hilar cholangiocarcinoma in 134 patients from 1999 to 2002, of whom 48 cases had received radical resection, we investigated the relationship between the characteristics and possible important related factors for longer survival. To strive to standardize the radical resection of hilar cholangiocarinoma, and have better curative effects as well as better survivals.Matrix metalloproteinase-2 (MMP-2), which degrades theextracellcular matrix or the basement membrane , has an essential role in tumor invasion and metastasis. To evaluate the roles of MMP-2 , its inhibitor ( tissue inhibitor of metalloproteinase-2[TIMP-2] ) , in tumor invasion or as a prognostic factor in patients with human hilar cholangiocarcinoma. We investigated the expression of MMP-2 and TIMP-2 in patients with human hilar cholangiocarcinoma. Tissues of paraffin sections obtained from 50 patients with human hilar cholangiocarcinoma were used for analysis. Expression of MMP-2 and TIMP-2 was examined by immunohistochemical analyses, and image analysis with Image ro Plus Analysis Software were used to semiquantitatively determine the ratio of MMP-2/TIMP-2.The main results of the study are as following:1. Actuarial survival at 1, 2, 3 years was 75.0%, 45.8%, 25. 0%, respectively. Survival was longer for patients who had curative resection than for those who had palliative resection. The main treatment of hilar cholangiocarinoma is operation, and radical resection plays an important role for curative effect and long term survival rate in patients with H-CC.2. MMP-2 and TIMP-2 expression levels are strongly associated with tumor hepatic invasion in patients with H-CC.3. There are significant differences in the ratio of MMP-2 to TIMP-2 expression between some pathologic factors in patients with H-CC.CONCLUSIONS:1. The main treatment of hilar cholangiocarinoma is operation, and radical resection plays an important role for curative effect and long term survival rate in patients with H-CC.2. MMP-2 has an essential role in tumor invasion and metastasis, while TIMP-2 is shown to strongly inhibit cancel-invasion and metastasis.3. The results of the current study suggest that the ratio of MMP-2/TIMP-2 may be a prognostic indicator for patients with human hilar cholangiocarcinoma.