| Background:Cholangiocarcinoma is generally considered an extremely aggressive carcinoma with a poor prognosis. Most of cholangiocarcinomas give rise to symptoms due to obstruction, caused not only by scirrhous invasion of carcinoma into the wall, but also by projection into the lumen. Although obstructive jaundice may appear at an early stage, the prognosis of the extrahepatic bile duct carcinoma is generally very poor. For cholangiocarcinomas, several prognostic factors have been clinicopathologically proposed, for example, tumor histologic type, location, clinical stage, venous invasion, lymphatic node metastasis and surgical resection margin. With the other carcinomas, cell adhesion molecules have been reported as useful prognostic indicators.Cell adhesion molecules (CAMs) is critical to the establishment and maintance of normal tissue architecture, which consist of five relevant families, ie, immunoglobulin superfamily, cadherins, selectins, integrins and CD44. At present, it has been known that the mutual adhesiveness of cancer cells is significantly weaker than that of the corresponding normal cells. Reducedcell-cell adhesiveness allows cancer cells to disobey the social order, resultingin destruction of the histological structure, the morphological hallmark of malignant tumors. Moreover, invasion and metastasis are the most life-threating properties of malignant tumors. The initial step in invasion and matastasis is the dissociation of cancer cells from the primary tumor through the breakdown of the cell-cell adhesion system. In particular, the cadherin and CD44 have been documented as important-modulators in this step. E-cadherin is calcium-dependent cell-cell adhesion transmenbrance glycoproteins present on most cells and which mediate homophilic adhesion between cells. Normal epithelial cells express immunoreactive E-cadherin at the cell membrance. Reduced or heterogenous expression of E-and, has been reported in a variety of cancers. The down-regulation of E-cadherin expression has been shown to correlate with tumor differentiation ^ invasion, lymph node metastasis x advanced stage and prognosis in a number of tumors including breast, esophageal, gastric, colorectal, pancreatic and bladder carcinomas. CD^ is present on the surface of many normal human epithelial and mesenchymal cells but is thought to function mainly in lymphocyte recirculation, adhesion, and activation, as well as in cell-cell and cell-matrix interaction. There have been conflicting results between CD^ve and tumor behavior. Although most preports suggested that up-regulation of CD44V6 has been associated with tumor progression, invasion and metastasis, as well as with patients' survival, some reports did not find any relationship between CD,uv6 expression and tumor behavior. However, there have been rarely comprehensive studies on E-cadherin and CD44V6 in cholangiocarcinoma. Therefore, in the current study, we immunohistochemically investigated the expression of E-cadhervin and CD/Hve in human normal bile duct and cholangiocarcinoma tissues, we also evaluated the correlations of their expression with prognostic factors of cholangiocarcinoma.Meterial and Methods:We collected 72 cases specimens including 10 cases of benign bile duct disease and 62 cases of cholangiocarcinoma. These tissues were fixed in 10% neutral buffered formalin and then embedded in paraffin. Five-micrometer-thick sections were cut and used for HE staining and immunohistochemical analysis. Immunohistochemical analyses with monoclonal antibodies against the human E-cadherin protein and CD44V6 protein were performed by S-P method. The relationship between expression of the E-cadherin > CD^ve and tumor location, pathological type, clinical UICC stage, tumor differentiation, prognosis was investingated. Statistical differences between groups were determined by % 2-test and the fisher exact probability test.Result:The high-expression rates of E-cadherin in noncancerous bile duct cells, cholangiocarcinoma tissues were 90%, 43.65% respectivel... |
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