The Expression And Biologic Significance Of CD44 Genic Albumen In Human Hilar Bile Duct Carcinoma

Bile duct carcinoma is a relatively rare form of digestion cancer. But the incidence had increased in the recent years, especially the hilar bile duct carcinoma. So the importance of study for the hilar bile duct carcinoma is increased. Some limited data suggest that the incidence in Asian region is surely higher than that in other continents. In our country the incidence is much more higher. The reason may be related to the high incidence of cholangitis and cholelithiasis in Asian region or in our country. Though the most bile duct carcinoma developed slowly the difficultness of early diagnosis of cholangiocarcinoma, the particular location of the tumor and the local irradiation to other tissue like blood vessels, nerves and liver lead to a lower radical excision. The prognosis is not satisfy. It was proved that the five year's survival of the cholangiocarcinoma patient was about 14%, and death usually were related to local tumor spread and the effects of biliary obstruction and cholangitis leading to liver failure. Therefore it is very for us important to further study invasion, metastasis of cholangiocarcinoma and seek for a way to improve the forward effectiveness of treatment for the carcinoma.The recent studies have indicated that the expression of CD44 albumen is closely related to the local irradiation of tumors. There are many studies about the relationship of the expression of CD44 albumen and the local irradiation of tumor, but most of them are about stomach cancer, colon cancer, hepatic cellular carcinoma, breast cancer, germarium adenocarcinoma and lung cancer, there is seldom studies about the relationship of CD44 and the irradiation of tumor in bile duct carcinoma, especially in human hilar bile duct carcinoma (HHC). It is hard to predict the prognosis of HHC in clinical. Some patients who were taken a radical excision sometime cannot survive longer than those who had received a palliative resection.Object: We used retrospective analysis of clinical data to investigate the situation of expression of CD44 in human hilar cholangiocarcinoma (HHC) . The second goal of this study is to investigate the correlation between the variant expression of CD44 in HHC and the invasion, metastasis and prognosis of HHC.Methods: 1. We select randomly sixty samples of HHC from the patients who had received an operation and the disease was identified by pathology during 1997 to 2001 and twenty normal bile duct samples. The different expression of two exons of CD44, CD44S and CD44V6, between two groups of samples was approached. 2. We divided all the 80 patients performed a radical excision during 1997 to 2001 into two groups, one group include 39 patients whosurvived longer than two years after operation, the other include 41 patients who survived less than two years after operation. The correlation of survival time and the different expression of CD44S and CD44V6 in HHC between two groups were approached.Results: The increased expression of CD44S and CD44V6 was observed in HHC compared to that in normal bile duct tissue (P<0.001) . The ratio expression of CD44S and CD44V6 in the patients who survived longer than two years after a radical excision is much lower than that in the other patients who can not survive for two years after a radical excision (P<0.05 )Conclusion: The increasing expression of CD44 in HHC contributes to the correct diagnosis of HHC. During the patients who had received a radical excision operation, the increase expression of CD44 especially of CD44V6 means that the tumor is more malignant and it is easy to irradiate or recurrence. So we should do something for those patients with higher expression of CD44 to prolong the survival.