Study Of The Expression And Clinical Significance Of Combined Detecting Annexin A1 And CA19-9 In Serum And Tissue Of Cholangiocarcinoma Patients

Cholangiocarcinoma is a originated in intrahepatic or extrahepatic bile duct epithelial malignant tumor, the global incidence and mortality are rising in recent years.With the development of imaging technology, clinical diagnosis of cholangiocarcinoma has made significant progress, but in the new tumor markers research progress is still slow. Annexin A1 involved in cell cycle regulation, proliferation, differentiation, apoptosis and other biological behaviour, and it is associated with the occurrence, development, metastasis and prognosis of many kinds of tumors. CA19-9 in diagnosis of cholangiocarcinoma and pancreas malignant tumor has higher sensitivity and specificity. But the relation between their expression in both serum and tissue and clinical pathological features(metastasis, clinical stage, pathological grade, tumor size) is not clear, especially detection of Annexin A1 in the serum correlation with cholangiocarcinoma has not been reported yet.The En VisionTM immunohistochemical technique was used to detect Annexin A1 and CA19-9 in cholangiocarcinoma tissue and enzyme-linked immunosorbent assay technique was used to detect Annexin A1 and CA19-9 in serum. It aimed to investigate below aspects: 1. To investigate the expression of Annexin A1 and CA19-9 in cholangiocarcinoma, tissue near by carcinoma and non-carcinoma bile duct tissue and their relationships with clinical pathological features. 2. To investigate the expression of Annexin A1 and CA19-9 in serum of cholangiocarcinoma patients, bile duct stones patients and healthy volunteers and their relationships with development of cholangiocarcinoma.Selection paraffin-embedded tissues 54 cases of cholangiocarcinoma, 54 cases of tissue near by carcinoma and 15 cases of non-carcinoma bile duct tissue(cyst of bile duct or bile duct injury) from the department of Pathology in the 251 st hospital of PLA ranging from February 2010 to April 2015. 24 cases serum of cholangiocarcinoma patients, 24 cases serum of bile duct stones patients, 20 cases serum of healthy volunteers were collected from the 251 st hospital of PLA ranging from August 2014 to April 2015. The expression of Annexin A1 and CA19-9 in the cholangiocarcinoma tissue and in the serum was detected. The relationships among the two markers with the patients’ age, the size of tumor, histological grade, TNM stage, metastasis of lymph nodes were analyzed.The positive rate of Annexin A1 in cholangiocarcinoma, tissue near by carcinoma and non-carcinoma bile duct tissue was 70.37%(38/54) 、33.33%(18/54)、6.67%(1/15), the difference was statistically significant(P<0.05); the positive rate of CA19-9 in cholangiocarcinoma, tissue near by carcinoma and non-carcinoma bile duct tissue was 74.07%(40/54) 、38.89%(21/54)、13.33%(2/15), the difference was statistically significant(P<0.05); the expression of Annexin A1 correlated with histological grade, TNM stage, metastasis of lymph nodes, while not correlated with the patients’ age and the size of tumor. The expression of CA19-9 correlated with metastasis of lymph nodes, while not correlated with the patients’ age, the size of tumor, histological grade and TNM stage.The positive cases of Annexin A1 and CA19-9 in the 54 cases of cholangiocarcinoma were 38, 40 respectively. 32 positive cases of CA19-9 aberrant expression were found in 38 positive cases of Annexin A1. Positive correlation was found through Spearman test between the expression of Annexin A1 and CA19-9(r=0.356, P<0.05).The average contents of Annexin A1 in the 24 cases serum of cholangiocarcinoma patients, bile duct stones patients and 20 cases serum of healthy volunteers were( 6.314±2.957) ng/ml,( 1.328±0.444) ng/ml,(1.105±0.416) ng/ml;The average contents of CA19-9 in the three kinds of serum were( 21.558±8.250) U/ml,( 2.088±0.711) U/ml,( 1.610±0.584) U/ml; The average contents of Annexin A1 and CA19-9 in cholangiocarcinoma patients were significantly higher than that in bile duct stones patients and healthy volunteers(P< 0.05); The average contents of Annexin A1 in cholangiocarcinoma preoperative and postoperative were( 6.314±2.957) ng/ml,(5.389±2.025) ng/ml, their expression difference was statistically significant(P>0.05); The average content of CA19-9 in cholangiocarcinoma preoperative was( 21.558±8.250) U/ml higher than that in postoperative( 12.131±0.886) U/ml(P<0.05).There was closely relation between the abnormal expression of Annexin A1 and CA19-9 and the development of cholangiocarcinoma. Annexin A1 and CA19-9 play a cooperative role in the occurrence, development, invasion and metastasis of cholangiocarcinoma. Co-detection of Annexin A1 and CA19-9 in serum and tissues might provide a theoretical basis for cholangiocarcinoma clinical screening, early diagnosis and prognosis assessment.