The Experimental Study On The Mode Of Invasion And Metastasis Of Hilar Bile Duct Carcinoma

HBDC are highly malignant tumors with poorprognosis. The spreading mode and mechanism of invasion andmetastasis are still confusing to many clinicians. The mostimportant factor affecting prognosis is "radical"resection of the tumcr. More under standing of the spreadof the cancer cells along the bile duct and nerves isneeded. According to this, we use computer technique andDNA microarray in the study.Objective: 1. To establish an algorithm of three-dimensionalresconstruction of HBDC.2. To find a reconstruction technique where all HBDCstructures can be individually or globally analyzedaccording to what is required.Methods: Taken from 3 paraffin-embedded tissues HBDCspecimens were cut into serial histologicsections. Information were inputted into computer after theprocessese of scanning and recognizing. By the techniques ofreconstruction, the 3D stereo HBDC models were retrievedfrom 2D digita1 data. Furthermore, we developed a cDNAarray representing 2048cDNA clusters, to profi1e the geneexpression patterns in 3 sets of c1inica1 HBDC samp1esinc1uding paired cancer and non--tumorous biliary duct.Results: 1. HBDC comprising severa1 components can beana1yzed as a who1e or each structure may be vieweds eparat e 1 y.2. It a1so show the re1ationships between the constituentparts such as bi1e duct and tumor.3. The 3D mode of spread a1ong nerve revealed that thetumor stayed sporadica1ly in perineural space.4. 1t was observed that 246 genes were differentia11yexpressed in paired cancer and distal non--tumorous bi1educt tissues. includes l64 down--regu1ated genes, 82 up-regu1ated genes. the 246 genes represent l5categori zations: l7 oncogenes, 4 ionic channe1 genes, 16cyc1 in genes, l2 cytoske1eton g3nes, 3 apoptosis genes, 4 DNAsynthesis and recombination genes, l7 DNA transcriptiongenes, 6 ce11 recipient genes, 1l inununization corre1atedgenes, 33 metabo1 ism genes, 30 protein translate andsynthesis genes, 10 growth correlated genes, 58 cel1 signa1and transducin genes, 57 other genes.Conclusion: 1. The method of the microcoInPuter aided 3Dreconstruction was suc.t5sfu11y estab1ished in HBDC.2. The reconstructed 3D image showed HBDC realistica11y.3. A11 structures reconstructed could be disp1ayed alone, inany group or total1y and rotated in 3D space or rotatedcontinuous1y at different speed.4. It can be app1ied in se1ecting the pattern of "radica1"resection and judge the resu1t of operation from the spreadof the cancer ce11s a1ong the bile duct and nerves.5. Such a series images of HBDC might be app1icated as acornerstone of the computer aid instruction in surgery.6. The differentia11y expressed genes was successfu11yscreened in HBDC.