Cytoplasmic overexpression with membrane accentuation of stratifin in intrahepatic mass-forming cholangiocarcinoma after hepatectomy: correlation with clinicopathologic features and patient survival.
OBJECTIVE
Cholangiocarcinoma (CCA) is a lethal malignancy that afflicts thousands of patients worldwide. Stratifin has been shown to participate in mediating G2 arrest in several cancers, and cells that express stratifin could contribute to the chemo- and radioresistance of cancers and poor prognosis. However, the clinical impact of stratifin on clinicopathological features of mass forming (MF)-CCA is still unclear.


METHODS
Seventy-eight patients with MF-CCA who had undergone hepatectomy were selected for an immunohistochemical study of stratifin. Sixteen clinicopathological variables were used for the survival analyses.


RESULTS
Seventy-eight MF-CCA patients (36 men and 42 women) were studied. Cytoplasmic immunostaining with membrane prominence was found in 52.6% (41/78) of patients with MF-CCA after hepatectomy; this was significantly associated with elevated carcinoembryonic antigen (CEA) levels. During the median follow-up duration of 13.6 months, the 5-year overall survival (OS) rate was 14.9%. Univariate analysis showed that an absence of clinical symptoms, better nutritional status, lower alkaline phosphatase, smaller tumor, negative lymph node metastasis, negative stratifin staining, and curative hepatic resection were associated with favorable OS rate for MF-CCA patients after hepatectomy. Multivariate Cox proportional hazard analysis showed that the absence of clinical symptoms, negative lymph node metastasis, and curative hepatectomy independently predicted MF-CCA patients with favorable OS rate after hepatectomy.


CONCLUSIONS
Overexpression of stratifin was significantly associated with elevated CEA levels in patients with MF-CCA. The favorable OS for MF-CCA patients depends on the absence of clinical symptoms, negative lymph node metastasis, and curative hepatectomy.
Yeh
Chun-Nan
CN
Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Pang
See-Tong
ST
Jung
Shih-Ming
SM
Chen
Tsung-Wen
TW
Jan
Yi-Yin
YY
Chen
Miin-Fu
MF
D048948:14-3-3 Proteins / Q000378:metabolism*; D000368:Aged; D001650:Bile Duct Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D002462:Cell Membrane / Q000378:metabolism; D018281:Cholangiocarcinoma / Q000378:metabolism* / Q000401:mortality* / Q000601:surgery; D003600:Cytosol / Q000378:metabolism; D005092:Exonucleases / Q000378:metabolism*; D005095:Exoribonucleases; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged
D048948:14-3-3 Proteins; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D005092:Exonucleases; D005095:Exoribonucleases; C413442:SFN protein, human