STUDY ON THE RELATIONSHIP BETWEEN LAMININ,67KDa LAMININ RECEPTOR AND INVASION,METASTASIS,PROGNOSIS OF HUMAN CHOLANGIOCARCINOMA

Bile duct carcinoma is a relatively rare form of cancer, but theincidence has increased in the recent years. Some limited data suggestthat the incidence in our country is surely higher than that in foreigncountries. The reason may be related to the high incidence ofcholangitis and cholelithiasis in our country Because the earlydiagnosis of cholangiocarcinoma is comparatively difficult, the tumorhave already spread locally when the patient came to see doctor. Therate of radical excision of cholangiocarcinoma is still quite low itsprognosis is poor. It was reported that the five years' survival of thecholangiocarcinoma patient was about 14%, and death usually wererelated to local tumor spread and the effects of biliary obstruction andcholangitis leading to liver failure. Therefore it is very for us importantto further study invasion, metastasis of cholangiocarcinoma anddetermine the factors influencing its prognosis.Laminin is one of the most important component of basementmembrane, which can adjust cohesion, spread and proliferation oftumor cell through combining with its receptor. 67KDa laminin receptoris a kind of membrane receptof, whose expression is closely correlated- 6 -lllllllg#&xA&x,#&M#$*ro$is5ff#. ff8foN$MinxttWrt mt,&t1 lllllllllllwith invasion. metastasis of boor. llllObjective: The goals of this stUdy are to (l)to investigate the llllcorrelation betWeen laminin. 67KDa laminin receptor expression and llll.. linvasion. metastasis. prognosis of hurnan cholangiocarcinoma. (2)tollldetermine the factors influencing the prognosis of cholangiocarcinoma llllpatient through multivariate analysis of clinical and pathological data. llllMethods: LN and 67KDaLN-R were immunohistochemically lllllocalized and quanitated by image analysis in 60 cases of llllcholangiocarcinoma. We implement multivariate analysis of clinical lllland pathological data (age. sex' albumen \ tumor position' CEA. llllCAl9-9' cholelithias' operation' jaundice' chemotheraPy' llllimmunotheraPy. pathological grade. intrahepatic invasion and/or llllmetastasis. laminin and 67KDa laminin receptor exPression) by Cox llllregression method. llllResults: LN were presented in continuous linear pattem around llllthe trabecular or acinar strUctUres in well-differentiated lllllcholangiocarcinoma and in discontinuous pattem in poor-differentiated llllcholangiocarcinoma. 67KDaLN-R were localized in either cytoplasm or llllmembranous surface of cholangiocarcinoma cells, especially in llllpoorly-differentiated cholangiocarcinoma. The increased expression of llll67KDaLN-R was observed in cholangiocarcinoma with intrahepatic llll.., linvasion and/or metastasis comPared to those without invasion orlllmetastasis (P<0.0l ) .Multivariate analysis of clinical and pathological lllldata by Cox regression method demonstrated that tumor position. llllll- 7 - lllllg$&ffieRx,#ffMff$+M$is4,&. ff#wffigrotoxttff% wt,&&x llllloperation. intrahepatic invasion and/or metastasis. LN-R expression llwere independent factors affecting the survival of cholangiocarcinoma llpatients. llConclusion:The changes of eXPression of LN and LN-R might be llcorrelated with invasion' metastasis and prognosis of llcholangiocarcinoma. Tumor position. operation. intrahepatic invasion lland/or metastasis were indePendent factors affecting the survival of llcholangiocarcinoma patients. It is importan for prolonging the survival llof cholangiocarcinoma patients to improve the early diagnosis level and llthe rate of radical excision. l...