Correlative Study Of Combined Detection Of MCM5and MUC4for Cholangiocarcinoma

Objective：Determine whether MCM5and MUC4as a reliable marker of cell proliferation, canaccurately reflect the cell proliferation activity that the biological behavior of bile duct, so asto provide the basis for the early diagnosis of cholangiocarcinoma. MUC4also studied theexpression of MCM5and can prompt the degree of malignancy and recurrence ofcholangiocarcinoma tendency, and thus for clinical diagnosis and prognosis of patients choosethe right treatment to help.Materials and methods：From Hebei University Hospital and252Hospital of PLA General Surgery andHepatobiliary Division collection cases.96cases, including malignant group (experimentalgroup):61cases, all the patients with cholangiocarcinoma, and TNM staging of all patients.Benign group (control group):35cases, including the bile duct, extrahepatic bile ductstricture, benign bile duct dilation of extrahepatic bile duct benign lesions. All cases wereconfirmed by surgery and diagnostic patients. Documented clinical data, intraoperative bileand bile duct puncture and biopsy specimens. In all cases micro-chromosome maintenanceprotein5(MCM5) and MUC4mucin in bile was determined by ELISA (enzyme-linkedimmunoassay), mini chromosome maintenance protein5(MCM5) and MUC4mucin incancer tissues was determined by SP method that streptomycin avidin-peroxidase. Results ofimage analysis, data were obtained using spss13.0package for statistical analysis.Results：MCM5and MUC4bile test results showed that compared with benign biliary tract, bileduct cancer group2kinds of tumor markers values were increased, with significant difference(P <0.05).Positive rates of two indicators: the benign lesions of the bile duct and MUC4MCM5the mean±standard deviation cut-off value is set, its value was23.5ug/l, and11.5ug/l. Asa cut-off value to determine the nature of benign and malignant bile MCM5and MUC4positive rate. Biliary tract disease and bile duct cancer group2positive rate indicators, twoindicators of bile duct cancer group were higher than the biliary tract benign disease group (P <0.05).MCM5and MUC4alone and combined test performance evaluation: MCM5asensitivity of48.3%, specificity92.1, positive predictive value85.1%, negative predictive value64.1%,71.1%accuracy. MUC4sensitivity of45.4%, specificity91.0, positivepredictive value81.0%, negative predictive value68.0%,68.0%accuracy. MCM5+MUC4(parallel experiment): sensitivity61.1%, specificity83.5, positive predictive value75.5%,negative predictive value63.5%,74.5%accuracy. MCM5+MUC4(a series of experiments)a sensitivity of37.3%, specificity of100%, positive predictive value of100%, negativepredictive value61.9%,73.2%accuracy.MCM5and MUC4in cholangiocarcinoma tissue and normal bile duct tissues: MCM5and MUC4expression in the cytoplasm, brownish yellow or brown particles. MCM5andMUC4is highly expressed in cholangiocarcinoma and in normal bile duct tissues noexpression, or only in the cytoplasm of bile duct epithelial cells, individual expression, but thepercentage of positive cells <10%. Cholangiocarcinoma group MCM5protein expression was73%, significantly higher than the normal group (X2=25.33, P <0.05).Cholangiocarcinoma MCM5and MUC4expression and clinical pathologic parameters:MCM5and MUC4expression and bile duct cancer patient’s age, gender were not correlated(P>0.05). The degree of tumor differentiation, distant metastasis, TNM stage correlated (P<0.05).MCM5and the correlation of MUC4expression in cholangiocarcinoma MUC4expression of MCM5and Spearman correlation test, a positive correlation between the twoexpression.(rp=0.9168, P <0.05)Conclusions：1.MCM5and MUC4direct response to the level of cell proliferation activity, and thus bydetecting MCM5and MUC4, the functional identification of the opposite sex from the cell,can contribute to the diagnosis of bile duct cancer and precancerous lesions for biopsycholangiocarcinoma the pathological examination to provide more effective aid.2. MCM5and MUC4can be a more accurate response to cell activity, and its expression leveland degree of tumor differentiation, and staging can be used as a more reliable marker for thediagnosis of cholangiocarcinoma. Treatment options and prognosis for a certain referencevalue.3. MCM5MUC4is closely related with the two combined detection of tumor markers maybecome cholangiocarcinoma diagnosis and prognosis of molecular markers.