Study On Clinical Stage And Prognosis Of Cholangiocarcinoma By Actin Family Member 26b

Objective:To study the expression of actin family member 26b(kif26b)in cholangiocarcinoma,analyze its correlation with clinicopathological features and prognosis,discuss its correlation with Ki-67,explore its role in invasion and metastasis of cholangiocarcinoma,explore new potential targets for early diagnosis and medication strategy of cholangiocarcinoma,and contribute to the treatment of cholangiocarcinoma.The ultimate goal is to improve the prognosis of patients.Methods:The expression difference of kif26b in pancarcinoma and cholangiocarcinoma and the correlation between the expression of kif26b and clinical data such as TNM stage and nerve invasion were analyzed by using Shengxin analysis tool in TCGA database.Paraffin sections and case data of 60 cases of cholangiocarcinoma(experimental group)and 20 cases of adjacent tissues(control group)were collected.The expression differences of kif26b and Ki-67 were detected by immunohistochemistry,and the correlation between kif26b and Ki-67 was analyzed by Spearman correlation coefficient test.The survival data of corresponding cholangiocarcinoma cases were obtained through follow-up.χ2 test was used to analyze the relationship between the differential expression of kif26b and Ki-67 and clinicopathological features such as patient age,gender,tumor tissue differentiation type,TNM stage,lymph node metastasis,tumor location,nerve invasion,carcinoembryonic antigen and CA-199.Kaplan Meier of log rank test was used to analyze the impact of the differential expression of kif26b and Ki-67 on the prognosis.Results:1.In TCGA database,kif26b was expressed differently in various malignant tumors and their corresponding adjacent tissues(P<0.001)(Fig.1),and there was a significant difference in the expression between cholangiocarcinoma and adjacent tissues(P<0.001)(Fig.2,Fig.3).The difference in kif26b expression was correlated with TNM stage and nerve invasion(P<0.001)(Fig.4).2.Immunohi stochemical staining showed that kif26b was expressed in cholangiocarcinoma and adjacent tissues,and the cytoplasm showed positive staining.The grading results of staining are shown in Figure 5,which are divided into negative(-),weak positive(+)and strong positive(+)according to the degree of staining.Kif26b was positively expressed in 6 cases(6/20)in adjacent tissues,and the positive expression rate was 30%,but there was no strong positive(+)expression.Correspondingly,a total of 40 cholangiocarcinoma tissue specimens showed positive expression(40/60),and the positive expression rate was 66.7%,of which 22 cases were strongly positive.Compared with adjacent tissues,kif26b was highly expressed in cholangiocarcinoma,and the difference was statistically significant(Table 1)(χ2=8.252,p=0.004<0.01).3.The positive expression of kif26b was related to tumor tissue differentiation type(P=0.005),TNM stage(P=0.037),lymph node metastasis(P=0.006)and nerve invasion(P=0.017),but not to gender,age,tumor location,CA-199 and carcinoembryonic antigen(P>0.05).4.Immunohistochemical method was used to detect the expression difference of Ki-67 in 60 cases of cholangiocarcinoma and whether there was nerve invasion.The expression of Ki-67 was limited to the nucleus.To summarize the relationship between Ki-67 expression and clinicopathological factors.The high expression of Ki-67 was significantly correlated with TNM stage(P=0.024)and lymph node metastasis(P=0.009).In most cases,tumors with high expression of kif26b also showed high expression of Ki-67 and nerve invasion.By Spearman correlation coefficient test,kif26b was positively correlated with Ki-67 on the basis of proliferative activity(P<0.01)(Table 2).5.The possible association between tumor expression of kif26b or Ki-67 and patient survival was evaluated by Kaplan Meier analysis of log rank test on OS(Fig.6).Patients with tumor high expression of kif26b had lower OS(P<0.001)(Fig.6a).Patients with tumors with high expression of Ki-67 had lower OS(P<0.05)(Fig.6b).In addition,with regard to the concomitant expression of kif26b and Ki-67 proteins,we divided the samples into three groups:group 1:tumors showed high expression of both kif26b and Ki-67.Group 2:tumor tissues highly expressed only one protein.Group 3:tumor tissues with low expression of both proteins.It is worth noting that the OS of group 3 was better than that of group 2 and the OS of group 1 was the worst(P<0.001)(Fig.6c),Survival analysis of RFS(recurrence free survival)and kif26b expression in patients also showed that RFSwas also lower in patients with high kif2b expression(P<0.05)(Fig.6d).Conclusion:Kif26b is highly expressed in cholangiocarcinoma,indicating that it is associated with the occurrence and development of tumors.In terms of clinical significance,the increased expression of kif26b is accompanied by the shortening of survival time,which leads to poor prognosis.In cholangiocarcinoma,the expression of kif26b was positively correlated with the expression of Ki-67 and nerve invasion.Kif26b may act together with Ki-67 through some mechanism to promote the progression of cholangiocarcinoma and jointly lead to the poor prognosis of patients with cholangiocarcinoma.