| BackgroundICC is the second most common primary liver cancer,which originates from the second stage and more peripheral bile duct.Recent studies have found that ICC is a series of heterogeneous cancer with different etiologies,locations,biological behavors and expression of related biomarkers.According to the location of ICC,it can be classified into peripheral type and perihilar type.It is revealed that these two types of ICC express different biomarkers of ICC,peripheral ICC tends to express high level of NCAM,Epcam and so on,then perihilar ICC is with a high expression of S100 P.Some researchers suggest that these findings reflect the different HPC origins of ICC.It has been proven that Hepatitis B is correlated to an increased risk of ICC incidence,but hepatitis related ICC tends to be quite a lower maliganence than ICC arising from other etiologies.Hepatitis related ICC mostly locate at the peripheral bile duct,thus,it is assumpted that hepatitis related ICC may stem from the HPC in Hering of Canal,where encompasses oval cells.So,hepatitis related ICC is regarded as a special type of ICC.It is promised by recent studies that epithelial-mesenchymal transition(EMT)palys an important role in the migration and progression of ICC.Our previous outcome of Mi RNA expression pattern found some MiRNAs expressed differently between hepatitis related ICC and non-hepatitis associated ICC,which can regulate the EMT process effectively.Thus,we suggerst the clinicopathological characteristics of hepatitis related ICC may be associated with the expressions of related molecular of HPC and EMT.MethodsAccording to our restrict inclusion and exclusion criterion,we retrieved and screened the ICC patients undergoing curative sugerry in our hospital between Jan 2008 and Dec 2009,then collect the clinicopathological and prognostic data of these patients.Firstly,the differences between ICC with positive serum of HbsAg and ICC with just positive serum of Hbc Ag were compared to reassure our classification standard.Secondly,hepatitis associated ICC group was compared with non-hepatitis ICC group to testify the clinicopathological characteristics of hepatitis associated ICC,which was defferent from ICC arising from other etiologies.At last,we examined the different expressions of biomkers of EMT(E-cadherin,N-cadherin,Vimentin)and HPC(CD133,NCAM2)between hepatiti associated ICC and non-hepatitis ICC.All the statistical procedures were conducted by utilizing SPSS 20.0 software.Outcomes1.Up to Oct 2010,96 in 124 ICC patients underwent tumor recurrence and 31 out of 124 patients remained alive.The 1-,3-,and 5-year OS rates were 63%,39% and 25%,respectively.The 1-,3-and 5-RFS rates were 48%,28% and 23%.2.COX single and multiple factors analysis revealed that tumor diameter larger than 5cm and history of hepatolithiasis were the indipedent risk factors for OS.however,tumor diameter larger than 5cm and perineural invasion were the indipedent risk factors for RFS.3.ICC with positive serum of HbsAg and ICC with just positive serum of HbcAg were different in clinicopathology and prognosis,thus we regarded ICC with just positive serum of HbcAg as non-hepatitis related ICC.4.Compared with non-hepatitis related ICC,hepatitis associated ICC tended to occur at an earlier age and show a high proportion of male cases.Non-hepatitis related ICC was liable to have an elevated level of AlP,?-GT and Ca19-9,while more hepatitis associated ICC patients had an elevated level of AFP.Hepatitis associated ICC was more likely to turn into peripheral type and mass-forming type with a lower rates of lymph node metastasis and perineural invasion.The1-,3-and 5-year RFS rates for hepatitis associated ICC group and non-hepatitis related group were 63% and 35%,41% and 17%,35% and 11%.The1-,3-and 5-year OS rates for hepatitis associated ICC group and non-hepatitis related group were 69% and 57%,51% and 28%,39% and 14%.5.There was no significant difference between hepatitis associated ICC and non-hepatitis related ICC in terms of expressions of E-cadherin,N-cadherin,Vimentin and CD133.But,hepatitis associated ICC tended to have a more frequent positive rates of NCAM2.E-N cadherin switch was correlated to tumor invasive behaviors including lymph node metastasis and perineural invasion.Non E-N cadherin switch group showed better survival rates not only in OS but also in RFS.The1-,3-and 5-year OS rates for nonE-N cadherin switch group and E-N cadherin switch group were 73% and 31%,45% and 24%,30% and 14%.The1-,3-and 5-year RFS rates for non-E-N cadherin switch group and E-N cadherin switch group were 57% and 21%,34% and 14%,27% and 10%.ConclusionHepatitis associated ICC is a special type of ICC,which is peripheral type in the majority and tends to have an high expression of NCAM2.There were no significant differences between non-hepatitis ICC group and hepatiti associated ICC group in terms of EMT related biomarkers.E-N cadherin switch is correlated to tumor invasive behaviors and is a risk factor for prognosis of ICC after curative surgery. |
PDF Full Text Request