| Hilar chilangiocarcinoma refers to the bile up to the gallbladder bile duct include common bile duct, right and left bile duct conflu-ence , left and right bile duct membrane epithelium cancer, and also named as the Klatskin tumor, the histological characteristics,are first detailed by Klatskin in 1965 and the this kind of pathological changes to caused the attention. Weinbern classified bile duct cancer accord-ing the histology characteristics into four kinds: (1) the free glue ma-terial exsits inside cell and extracellular matrix components (2) the normal construction of bile duct gland and tumor jamed; ( 3 ) invading : tumor cells directly invaded into the hepatic cells or the bile wall and the material around the bile, and vessel , nerve and between the nerve and lymph (4) the cancer cell can expand under the complete bile duct membrane, the Transfer characteristics; hilar chilangiocarcinoma mostly belong to high grade adenocarcinoma . it mostly transfer to nerve, this expand form as well see in the pancreas cancer, the occur-rence rate is 80% - 100%. It is possible related to this two type tumor of the poorly surgical resection and that high relapse rate, the reason of the invading of nerve and the nerve surrounding is not clear-ly, somebody thought it is the behave of the tumor invading to the mostly weak defending. In 1992 the Bhuiya et at . discovers the pa-tients with nerve invaded, the 5 years survival rate postoperation is more lower than the no invaded (32% : 67% ). It explained that the the nerve invasion is likely to very important factor to the relapse after the resection, the clinical pathology type consisted of : (1) polyp or papillary cancer ( 2 ) nodus type ( 3 ) scleroses ( 4 ) invading, clinical stage according to Bismuth clinical stage, is according to the primitive tumor where the part is divided into 4 type, the great majority is a ad-enocarcinoma, in addition, and ring ?cancer etc. . Because of charac-teristic of the hilar cholangiocarcinoma growing, it make surgical re-section rate and the rate of living postoperation are very low. According to foreign articles the surgical resective rate is 25 -78.7% , the totally living of 5years postoperation is 7% - 16%. It is the most important factor of the low rate that are tumor invaded and transfer.In this research the immunohistochemnical staining method used to examination the expression of Cath - D with TGF ?pi in the hilar changliocarcinoma and study the relation of these factors with infiltra-tion, metastasis and prognosis, in order to improve the preparing and curing the tumor to provide the emollient theories the basis.78 cases of hilar cholangiocarcinoma with integrity data were in-cluded in this research ; these were under operation in our hospital during 1993 -2000. The results as follows:(1) the postive rate of Cath - D in hilar cholangiocarcinoma is 65. 34% , among the high - expression group ,the positive rate is 59. 68% ,negative is 37.5% . Both are not different (P >0.05). It can conclude that Cath - D is not related to the dififerentiation of the canc-er. During the infiltration group the positive rate is 50% , but the ne-giative is 22.92% , they are relative ( P < 0. 05 ). It hints that if Cath- D is high ,the aggression is deep. During the lymph node matastasis group the positive is 76. 92% , is different from the non - matastasis group (P <0.05). If the level is high,the matastasis occurred. All of the reveals are same with Kiluk and Kantsdi Is study on the colon cancer.The function of Cath - D on the hilar cholangocarcinoma are that stimulating the cells growing and destroying the basal membrane and ECM. It can help cancer metastasis and infilation.The positive rate of TGF - β1 of the high differentiation group is 48. 39% ,or the negative is 50%. Both are the same ( P > 0. 05 ). the lymph node group is similar to the differentiate group. Among the infi-lation group the positive is 43. 75% ,is quite different from the nega-tive (P>0.05).The average postoperative living time of the high... |
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