Combined Detection Of ADAM-17 And ERBB1 Expression In Cholangiocarcinoma And Its Clinical Significance

Objective: Immunohistochemical staining(Immunohistochemistry,IHC)was used to detect the difference between the expression of disintegrin-metalloproteinase-17(adisintegrinandmetalloprotease17,ADAM-17)and epidermal growth factor receptor 1(humanepidermalgrowthfactorreceptor-1,ERBB1/Her1)in cholangiocarcinoma and adjacent normal bile duct tissues,and to analyze whether there was a relevance between their expression and clinicopathological factors in patients with cholangiocarcinoma.To further study the role of both in the occurrence and progression of cholangiocarcinoma,and to explore the prognostic factors of patients with cholangiocarcinoma.Methods:From January 2015 to December 2019,60 cases of archival tissue wax were collected from the Department of Hepatobiliary surgery of the people's Hospital of Inner Mongolia Autonomous region.The experimental group was cholangiocarcinoma tissue.The control group was normal bile duct tissue adjacent to cancer in the same patient(no cancer cells were confirmed by pathology).Immunohistochemical technique was used to discover the expression of ADAM-17 and ERBB1 in cholangiocarcinoma and adjacent normal bile duct tissues.According to the clinical and pathological data,the patients were divided into 11groups: age,sex,tumor location,tumor size,differentiation,lymphatic metastasis,T stage,nerve invasion,vascular invasion,CA199 level and CA125 level.To analyze the relativity between the expression of ADAM-17 and ERBB1 and various factors,and their role in the occurrence and progression of cholangiocarcinoma.Follow-up was conducted to study the prognostic factors of patients with cholangiocarcinoma.SPSS17.0 statistical software was used to analyze all the data,whether there was a difference in the expression of the two proteins between the cancer tissue and the normal bile duct tissue adjacent to the cancer,andthe correlation between the expression of the two proteins in the cancer tissue and the grouping factors was analyzed by chi-square test,and SPEARMAN rank correlation was used to analyze the correlation between the expression of the two proteins in the cancer tissue,P value <0.05 was statistically significant.The survival time curve was drawn by Kaplane-Meier method,and the single factor analysis which might be related to prognosis was tested by log-rank method,and the variables with P < 0.05 were selected into COX stepwise regression model for multivariate analysis.Multivariate analysis showed that the variables with P < 0.05 were independent risk factors affecting the prognosis of patients with cholangiocarcinoma.Results:1.The expression level of ADAM-17 protein in cholangiocarcinoma tissues was remarkably different from that in paracancerous normal bile duct tissue(P=0.001);the expression level of ADAM-17 protein was significantly correlated with age ?65 years,tumor size ?2 cm,poor differentiation of tumors,positive lymphatic metastasis,T stage(T3+T4),positive vascular invasion,and CA199 level ?39U/m L(P=0.007,0.015,0.001,0.010,0.005,0.012,0.021),which was also statistically significant.However,it was not correlated with gender,tumor location,nerve invasion and CA125 level(P=0.235,0.265,0.078,0.107),and there was no statistical significance.2.The expression level of ERBB1 protein in cholangiocarcinoma tissues was conspicuously different from that in paracancerous normal bile duct tissue(P=0.001);the expression level of ERBB1 protein was significantly correlated with age ?65 years,poor differentiation of tumors,positive lymphatic metastasis,T stage(T3+T4)stage,and CA199 level ?39U/ m L(P=0.002,0.006,0.001,0.000,0.007),with statistical significance.There were no significant differences in gender,tumor location,tumor size,neurological invasion,vascular invasion,and CA125 level between the two groups(P=0.562,0.195,0.248,0.055,0.712,0.071).3.The results of SPEARMAN rank correlation analysis showed that there was a positive correlation between ADAM-17 and ERBB1 in the high surface of cholangiocarcinoma tissues,and the correlation coefficient was 0.658,P <0.01,suggesting that there was a synergistic effect between them.4.Univariate analysis showed that high expression of ADAM-17 and ERBB1 protein,age ? 65 years old,tumor size? 2cm,poor tumor differentiation,positive lymphatic metastasis,T stage(T3+T4),positive nerve invasion and preoperative CA199 ? 39U/m L were significantly correlated with poorpostoperative prognosis in patients with cholangiocarcinoma.Multivariate analysis showed that high expression of ADAM-17 and ERBB1,low degree of tumor differentiation,positive lymph node metastasis and T stage(T3+T4)were independent risk factors affecting the prognosis of patients with cholangiocarcinoma after radical resection.Conclusion:1.The expression of ADAM17 and ERBB1 in cholangiocarcinoma tissues was higher than that in adjacent normal bile duct tissues.2.The high expression of ADAM-17 and ERBB1 was associated with age ? 65 years,low tumor differentiation,lymphatic metastasis,T stage(T3+T4)and CA199 ? 39U/m L,and they had synergistic effect,indicating that they are risk factors for the occurrence,progression,invasion and migration of cholangiocarcinoma.3.High expression of ADAM-17 and ERBB1,low degree of tumor differentiation,lymphatic metastasis and T stage(T3+T4)are independent risk factors affecting the prognosis of patients with cholangiocarcinoma,suggesting that the survival time of patients is short and the prognosis is poor,which has important clinical significance in predicting the prognosis of cholangiocarcinoma.4.ADAM-17 and ERBB1 may be used as indicators to guide postoperative treatment of cholangiocarcinoma patients,which is expected to provide a new target for targeted therapy and bring good news to patients in the future.