Expression Of S100A9 In Distal Bile Duct Carcinoma And Its Clinical Significance

Objective:Patients with cholangiocarcinoma have no obvious symptoms in the early stage.Most of them are get diagnosis in advanced stages and lost the chance of radical surgery.Earlier diagnosis is the key to the treatment of cholangiocarcinoma.Traditional diagnostic methods have limited value for the early diagnosis of cholangiocarcinoma.Finding reliable tumor biomarkers may be a breakthrough point for the early diagnosis.In our earlier experiments,we found that S100A9 was differentially expressed in cholangiocarcinoma tissues and normal control tissues.In this study,we investigated the expression of S100A9 in distal cholangiocarcinoma and clarify its relationship with clinicopathological features and postoperative prognosis of distal bile duct cancer patients.We aimed to find practical tumor biomarkers for early diagnosis and prognosis of cholangiocarcinoma.Methods:All cancer tissues and corresponding paracancerous tissues were pathologically confirmed as the distal bile duct cancer after pancreatoduodenectomy,and collected from the Department of Hepatobiliary Surgery of Hunan Provincial People's Hospital from January 1,2014 to December 1,2015.The expression of S100A9 was detected by immunohistochemistry in 50 cases,then the relationship between the expression of S100A9 and the clinicopathological features of distal bile duct cancer patients were analyzed.Kaplan-Meier estimator was used to perform univariate survival analysis to screen possible prognostic factors for distal bile duct cancer and verify the results in a multi-factor Cox regression model.Results:1.The results of immunohistochemistry showed that S100A9 was mainly expressed in cytoplasm in cancer tissues and corresponding paracancerous tissues,and was expressed in both nucleus and cell membrane.The positive expression rate of S100A9 in cancer tissue was 84.00%,and that of S100A9 in paracancerous tissues was 24.00%.There was a significant difference between the two groups(P<0.05).2.According to the clinical factors,the differences in expression of S100A9 between different subgroups were evaluated.The results suggested that the expression of S100A9 was related to tumor TNM stage,lymph node metastasis,and tumor differentiation(P<0.05),and there was no significant correlation with gender,age,tumor diameter,and degree of tissue infiltration(P>0.05).3.4 out of 50 patients survived as censored data in our study,with a censor rate of 8%.Kaplan-meier univariate survival analysis showed that the survival time of patients with distal bile duct cancer was related to the expression of S100A9,TNM stage and tumor differentiation(P<0.05).Multivariate Cox regression analysis suggested that TNM stage and the expression of S100A9 were independent prognostic factors in patients with distal bile duct cancer.The prognosis of patients with distal bile duct carcinoma with low expression of S100A9 and earlier TNM staging was better than high expression of S100A9 and later TNM staging.Conclusion:The expression of S100A9 is higher in cancer tissues than in paracancerous tissues.is related to TNM staging,lymph node metastasis,and tumor differentiation.The expression of S100A9 and TNM stage was independent prognostic factors of distal bile duct cancer.The abnormal expression of S100A9 in cholangiocarcinoma suggests that it may be involved in the occurrence and development of cholangiocarcinoma,and S100A9 has potential to become a tumor biomarker for early diagnosis and prognosis of cholangiocarcinoma.