1
|
Gao S, Sun W, Zhang Y, Wang F, Jin K, Qian X, Han J, Wang X, Dai Y, Sheng R, Zeng M. Correlation analysis of MR elastography and Ki-67 expression in intrahepatic cholangiocarcinoma. Insights Imaging 2023; 14:204. [PMID: 38001349 PMCID: PMC10673794 DOI: 10.1186/s13244-023-01559-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Intrahepatic cholangiocarcinoma (iCCA) is an aggressive primary liver cancer with dismal outcome, high Ki-67 expression is associated with active progression and poor prognosis of iCCA, the application of MRE in the prediction of iCCA Ki-67 expression has not yet been investigated until now. We aimed to evaluate the value of magnetic resonance elastography (MRE) in assessing Ki-67 expression for iCCA. RESULTS In the whole cohort, 97 patients (57 high Ki-67 and 40 low Ki-67; 58 males, 39 females; mean age, 58.89 years, ranges 36-70 years) were included. At the multivariate analysis, tumor stiffness (odds ratio (OR) = 1.669 [95% CI: 1.307-2.131], p < 0.001) and tumor apparent diffusion coefficient (ADC) (OR = 0.030 [95% CI: 0.002, 0.476], p = 0.013) were independent significant variables associated with Ki-67. Areas under the curve of tumor stiffness for the identification of high Ki-67 were 0.796 (95% CI 0.702, 0.871). Tumor stiffness was moderately correlated with Ki-67 level (r = 0.593, p < 0.001). When both predictive variables of tumor stiffness and ADC were integrated, the best performance was achieved with area under the curve values of 0.864 (95% CI 0.780-0.926). CONCLUSION MRE-based tumor stiffness correlated with Ki-67 in iCCA and could be investigated as a potential prognostic biomarker. The combined model incorporating both tumor stiffness and ADC increased the predictive performance. CRITICAL RELEVANCE STATEMENT MRE-based tumor stiffness might be a surrogate imaging biomarker to predict Ki-67 expression in intrahepatic cholangiocarcinoma patients, reflecting tumor cellular proliferation. The combined model incorporating both tumor stiffness and apparent diffusion coefficient increased the predictive performance. KEY POINTS • MRE-based tumor stiffness shows a significant correlation with Ki-67. • The combined model incorporating tumor stiffness and apparent diffusion coefficient demonstrated an optimized predictive performance for Ki-67 expression. • MRE-based tumor stiffness could be investigated as a potential prognostic biomarker for intrahepatic cholangiocarcinoma.
Collapse
Affiliation(s)
- Shanshan Gao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Wei Sun
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Yunfei Zhang
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
- Central Research Institute, United Imaging Healthcare, Shanghai, 201800, China
| | - Feihang Wang
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Kaipu Jin
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Xianling Qian
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Jing Han
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Xiaolin Wang
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yongming Dai
- Central Research Institute, United Imaging Healthcare, Shanghai, 201800, China
| | - Ruofan Sheng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Fujian, 361006, China.
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
- Department of Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| |
Collapse
|
2
|
Ji F, Kang Q, Wang L, Liu L, Ke Y, Zhu Y, Zhang N, Xiong S, Li Y, Zou H. Prognostic significance of the neutrophil-to-lymphocyte ratio with distal cholangiocarcinoma patients. Medicine (Baltimore) 2020; 99:e22827. [PMID: 33120809 PMCID: PMC7581158 DOI: 10.1097/md.0000000000022827] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The present study aimed to investigate the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in distal cholangiocarcinoma (DCC) following radical surgery. METHODS The clinicopathological data of 59 patients with DCC were retrospectively reviewed. Patients were treated by radical surgery and diagnosed by postoperative pathology at the Second Affiliated Hospital of Kunming Medical University (Yunnan, China), between July 2015 and December 2017. The optimal cut-off value for the NLR was determined by generating receiver operating characteristic (ROC) curves. Kaplan-Meier survival analysis and Cox proportional hazards models were used to determine the risk factors and independent risk factors influencing the prognosis of patients with DCC. RESULTS According to the ROC curve, the optimal cut-off value for the NLR was 2.933. The results of Kaplan-Meier survival analysis and the Cox proportional hazards model showed that carbohydrate antigen 125, NLR, perineural, vascular and fat invasion, regional lymph node metastasis, and the American Joint Committee on Cancer stage were risk factors for DCC; the only independent risk factor to affect the prognosis of DCC patients was the NLR. CONCLUSIONS The preoperative NLR plays an important guiding role in evaluating the prognosis of patients with DCC, and an increase in the NLR is associated with poor patient prognosis.
Collapse
Affiliation(s)
- Fengming Ji
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital
- Urology Department of The Affiliated Children's Hospital of Kunminng Medical University, Kunming Chlidren's Hospital, Key Laboratory of Children's Major Disease Research, Kunming Medical University
| | - Qiang Kang
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital
| | - Lianmin Wang
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital
| | - Lixin Liu
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital
| | - Yang Ke
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital
| | - Ya Zhu
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital
| | - Naiqiang Zhang
- Department of General Surgery, Kunming Traditional Chinese Medicine Hospital, Kunming, Yunnan, PR China
| | - Shifeng Xiong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital
| | - Yuehua Li
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital
| | - Hao Zou
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital
| |
Collapse
|
3
|
Jones RP, Bird NTE, Smith RA, Palmer DH, Fenwick SW, Poston GJ, Malik HZ. Prognostic molecular markers in resected extrahepatic biliary tract cancers; a systematic review and meta-analysis of immunohistochemically detected biomarkers. Biomark Med 2015. [PMID: 26223884 DOI: 10.2217/bmm.15.48] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
UNLABELLED Better prognostic information for resected extrahepatic cholangiocarcinoma could guide treatment strategies and potentially improve outcome. This study performed a systematic review and meta-analysis to identify prognostic biomarkers for further investigation. METHODS Relevant literature was identified using Medline, EMBASE and Web of Science. Primary end point was overall survival assessed on univariate analysis. Log hazard ratio and variance were calculated and pooled using a random effects inverse variance approach. Hazard ratio and 95% confidence intervals were calculated. RESULTS Thirty-seven studies, including 2371 patients, met the inclusion criteria. Subsequently nine biomarkers predictive of OS were identified (HR, 95% CI): VEGF (2.32, 1.57-3.44), COX-2 (1.94, 1.01-3.71), GLUT-1 (2.09, 1.52-2.89), Cyclin D1 (1.96, 1.02-3.76), p16 (0.68, 0.47-0.98), p27 (0.48, 0.3-0.78), E-Cadherin (0.47, 0.35-0.63), Fascin (2.19, 1.35-3.55), and Ki-67 (1.69, 1.02-2.79). CONCLUSION Meta-analysis has identified a number of prognostic biomarkers for resected extrahepatic cholangiocarcinoma. These markers warrant further investigation as potential therapeutic targets and validation in a prospective setting.
Collapse
Affiliation(s)
- Robert P Jones
- School of Cancer Studies, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 7ZK, UK.,Liverpool Hepatobiliary Unit, Aintree University Hospital, Liverpool, L9 7AL, UK
| | - Nicholas T E Bird
- Liverpool Hepatobiliary Unit, Aintree University Hospital, Liverpool, L9 7AL, UK
| | - Richard A Smith
- Liverpool Hepatobiliary Unit, Aintree University Hospital, Liverpool, L9 7AL, UK
| | - Daniel H Palmer
- School of Cancer Studies, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 7ZK, UK.,Liverpool Hepatobiliary Unit, Aintree University Hospital, Liverpool, L9 7AL, UK
| | - Steven W Fenwick
- Liverpool Hepatobiliary Unit, Aintree University Hospital, Liverpool, L9 7AL, UK
| | - Graeme J Poston
- Liverpool Hepatobiliary Unit, Aintree University Hospital, Liverpool, L9 7AL, UK
| | - Hassan Z Malik
- Liverpool Hepatobiliary Unit, Aintree University Hospital, Liverpool, L9 7AL, UK
| |
Collapse
|
4
|
Welling TH, Feng M, Wan S, Hwang SY, Volk ML, Lawrence TS, Zalupski MM, Sonnenday CJ. Neoadjuvant stereotactic body radiation therapy, capecitabine, and liver transplantation for unresectable hilar cholangiocarcinoma. Liver Transpl 2014; 20:81-8. [PMID: 24115315 PMCID: PMC4185427 DOI: 10.1002/lt.23757] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 09/13/2013] [Indexed: 12/17/2022]
Abstract
Hilar cholangiocarcinoma (CCA) is a difficult malignancy to treat surgically because of its anatomical location and its frequent association with primary sclerosing cholangitis. Neoadjuvant chemoradiotherapy followed by liver transplantation in lymph node-negative patients has been advanced by select liver transplant centers for the treatment of patients with unresectable disease. This approach has most commonly used external-beam radiotherapy in combination with biliary brachytherapy and 5-fluorouracil-based chemotherapy. Our center recently embarked on a protocol using stereotactic body radiation therapy (SBRT) followed by capecitabine in lymph node-negative patients until liver transplantation. We, therefore, retrospectively determined the tolerability and pathological response in this pilot study. During a 3-year period, 17 patients with unresectable hilar CCA were evaluated for treatment under this protocol. In all, 12 patients qualified for neoadjuvant therapy and were treated with SBRT (50-60 Gy in 3-5 fractions over the course of 2 weeks). After 1 week of rest, capecitabine was initiated at 1330 mg/m(2) /day, and it was continued until liver transplantation. During neoadjuvant therapy, there were 35 adverse events in all, with cholangitis and palmar-plantar erythrodysesthesia being the most common. Capecitabine dose reductions were required on 5 occasions. Ultimately, 9 patients were listed for transplantation, and 6 patients received a liver transplant. The explant pathology of hilar tumors showed at least a partial treatment response in 5 patients, with extensive tumor necrosis and fibrosis noted. Additionally, high apoptotic indices and low proliferative indices were measured during histological examinations. Eleven transplant-related complications occurred, and the 1-year survival rate after transplantation was 83%. In this pilot study, neoadjuvant therapy with SBRT, capecitabine, and liver transplantation for unresectable CCA demonstrated acceptable tolerability. Further studies will determine the overall future efficacy of this therapy.
Collapse
Affiliation(s)
- Theodore H Welling
- Department of Surgery, University of Michigan Medical School, Ann Arbor, MI
| | | | | | | | | | | | | | | |
Collapse
|
5
|
The DNA index is a strong predictive marker in intrahepatic cholangiocarcinoma: the results of a five-year prospective study. Surg Today 2013; 44:1336-42. [DOI: 10.1007/s00595-013-0701-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 07/16/2013] [Indexed: 01/04/2023]
|
6
|
Kong D, Liang J, Li R, Liu S, Wang J, Zhang K, Chen D. Prognostic significance of snail expression in hilar cholangiocarcinoma. Braz J Med Biol Res 2012; 45:617-24. [PMID: 22570087 PMCID: PMC3854268 DOI: 10.1590/s0100-879x2012007500070] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 04/13/2012] [Indexed: 12/02/2022] Open
Abstract
Many patients with hilar cholangiocarcinoma (HC) have a poor prognosis. Snail, a transcription factor and E-cadherin repressor, is a novel prognostic factor in many cancers. The aim of this study was to evaluate the relationship between snail and E-cadherin protein expression and the prognostic significance of snail expression in HC. We examined the protein expression of snail and E-cadherin in HC tissues from 47 patients (22 males and 25 females, mean age 61.2 years) using immunohistochemistry and RT-PCR. Proliferation rate was also evaluated in the same cases by the MIB1 index. High, low and negative snail protein expression was recorded in 18 (38%), 17 (36%), and 12 (26%) cases, respectively, and 40.4% (19/47) cases showed reduced E-cadherin protein expression in HC samples. No significant correlation was found between snail and E-cadherin protein expression levels (P = 0.056). No significant correlation was found between snail protein expression levels and gender, age, tumor grade, vascular or perineural invasion, nodal metastasis and invasion, or proliferative index. Cancer samples with positive snail protein expression were associated with poor survival compared with the negative expresser groups. Kaplan-Meier curves comparing different snail protein expression levels to survival showed highly significant separation (P < 0.0001, log-rank test). With multivariate analysis, only snail protein expression among all parameters was found to influence survival (P = 0.0003). We suggest that snail expression levels can predict poor survival regardless of pathological features and tumor proliferation. Immunohistochemical detection of snail protein expression levels in routine sections may provide the first biological prognostic marker.
Collapse
Affiliation(s)
- Dalu Kong
- Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, Hexi District, Tianjin, China
| | | | | | | | | | | | | |
Collapse
|
7
|
Pabst C, Zustin J, Jacobsen F, Luetkens T, Kröger N, Schilling G, Bokemeyer C, Sauter G, Atanackovic D, Marx A. Expression and prognostic relevance of MAGE-C1/CT7 and MAGE-C2/CT10 in osteolytic lesions of patients with multiple myeloma. Exp Mol Pathol 2010; 89:175-81. [PMID: 20621094 DOI: 10.1016/j.yexmp.2010.06.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Accepted: 06/30/2010] [Indexed: 10/19/2022]
Abstract
Cancer-testis (CT) antigens are promising targets for antigen-specific therapy of multiple myeloma (MM). Osteolytic lesions represent the most common clinical manifestation of myeloma and it is possible that osseous myeloma lesions differ from bone-infiltrating tumor cells with regard to the extent of CT antigen expression based on the epigenetic regulation of these genes. We, therefore, performed the first analysis of CT antigen expression in osteolytic lesions of myeloma patients to further define the diagnostic, prognostic, and therapeutic value of these proteins. Lytic bone samples were obtained from MM patients during surgical interventions and a tissue microarray was constructed. 105 bone samples and 24 bone marrow biopsies were stained immunohistochemically with antibodies against CT antigens MAGE-C1/CT7 and MAGE-C2/CT10 and Ki-67. MAGE-C1/CT7 and MAGE-C2/CT10 were frequently expressed in osteolytic lesions (46% and 54%) and bone marrow (75% and 54%). Expression of MAGE-C1/CT7 was significantly more frequent in patients with advanced stage of disease (p=0.023) and with a chromosomal deletion 17p13 (p53) (p=0.047). Samples with more than 75% MAGE-C1/CT7 expressing myeloma cells showed a higher proliferative rate (indicated by the expression of Ki67) than those with less than 25% MAGE-C1/CT7 expressing cells (p=0.011). Moreover, a content of ≥50% MAGE-C1/CT7 expressing myeloma cells in a sample was associated with reduced overall survival (p=0.013). Our results, therefore, suggest that expression of MAGE-C1/CT7 and MAGE-C2/CT10 in osteolytic lesions of myeloma patients can be used for diagnostic, prognostic, as well as immunotherapeutic purposes.
Collapse
Affiliation(s)
- Caroline Pabst
- Department of Oncology/Hematology/Bone Marrow Transplantation with the section Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Briggs CD, Neal CP, Mann CD, Steward WP, Manson MM, Berry DP. Prognostic molecular markers in cholangiocarcinoma: a systematic review. Eur J Cancer 2008; 45:33-47. [PMID: 18938071 DOI: 10.1016/j.ejca.2008.08.024] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2008] [Revised: 08/06/2008] [Accepted: 08/26/2008] [Indexed: 12/24/2022]
Abstract
The worldwide incidence of cholangiocarcinoma (CC) is steadily rising, with the incidence in United Kingdom (UK) now exceeding 1000 cases per year. It is an aggressive malignancy typified by unresponsiveness to the existing chemotherapy and radiotherapy regimes in the vast majority of cases. Surgery offers the only hope of a cure, though post-operative disease recurrence is common, with 5-year survival rates of less than 25% following resection. Developments in molecular techniques and improved understanding of the basis of carcinogenesis in CC has led to examination of the role of biomarkers in predicting poor outcome. This systematic review examines published evidence relating to the prognostic significance of these molecular markers in CC. Of the molecular markers which have been investigated to date, p53 mutation, cyclins, proliferation indices, mucins, CA19-9, CRP and aneuploidy appear to hold significant potential as predictors of outcome in CC. These and other biomarkers may themselves represent novel therapeutic targets for CC.
Collapse
Affiliation(s)
- Christopher D Briggs
- Cancer Biomarkers and Prevention Group, Department of Cancer Studies and Molecular Medicine, Biocentre, University of Leicester, Leicester, United Kingdom.
| | | | | | | | | | | |
Collapse
|
9
|
Cheng Q, Luo X, Zhang B, Jiang X, Yi B, Wu M. Distal bile duct carcinoma: prognostic factors after curative surgery. A series of 112 cases. Ann Surg Oncol 2006; 14:1212-9. [PMID: 17176983 DOI: 10.1245/s10434-006-9260-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2006] [Revised: 09/28/2006] [Accepted: 10/04/2006] [Indexed: 01/25/2023]
Abstract
BACKGROUND The identification of independent prognostic indicators in distal bile duct carcinomas (DBDCs) has been limited by the small number of tumors and a lack of molecular prognostic markers. Markers assessed in combination may perform better than those considered individually. We conducted this study to identify prognostic predictors of patients with DBDC with special focus on combination of expression of p53 protein and clinicopathological predictors. METHODS Between December 1996 and 2002, 112 consecutive patients undergoing pancreaticoduodenectomy in the Eastern Hepatobiliary Surgery Hospital for distal bile duct carcinomas were identified in a prospectively collected database. The survival of patients was comparable with respect to patient characteristics, clinicopathological factors and degree of p53 protein expression followed by a univariate and multivariate analysis. RESULTS Actual 1, 3, and 5-year survival rates were 85.7, 50.9, and 25.0%, respectively. By Cox proportional hazards survival analysis, the most powerful predictors of survival rate were p53 expression [relative risk (RR) 5.2, 95% CI 4.8-5.6], pancreatic invasion (RR 5.6, 95% CI 4.3-6.9), lymph nodes metastasis (RR 3.9, 95% CI 3.3-4.5), and operative time (RR 1.8, 95% CI 1.5-2.1). CONCLUSIONS Overexpression of p53 in DBDC is strongly associated with significantly reduced survival, independently of clinicopathological prognostic factors. The resection margin status provides little independent prognostic information. Longer operative time may have unfavorable effect on prognosis of patients with DBDC.
Collapse
Affiliation(s)
- Qingbao Cheng
- Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Changhai Road 225, Shanghai, 200438, China
| | | | | | | | | | | |
Collapse
|
10
|
Lehmann J, Retz M, Nürnberg N, Schnöckel U, Raffenberg U, Krams M, Kellner U, Siemer S, Weichert-Jacobsen K, Stöckle M. The superior prognostic value of humoral factors compared with molecular proliferation markers in renal cell carcinoma. Cancer 2004; 101:1552-62. [PMID: 15378494 DOI: 10.1002/cncr.20549] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The American Joint Committee on Cancer and the Union Internationale Contre le Cancer have acknowledged routine laboratory parameters, such as serum calcium, alkaline phosphatase, hemoglobin, and the erythrocyte sedimentation rate (ESR), as predictors of survival in patients with renal cell carcinoma. The predictive value of these parameters compared with proliferation markers, such as Ki-67, proliferating cell nuclear antigen (PCNA), topoisomerase II-alpha, and p100, has not been determined. METHODS Forty-eight consecutive patients who underwent nephrectomy for nonmetastatic renal cell carcinoma between 1990 and 1994 were observed up to 120 months postoperatively. Ten of 48 patients developed tumor progression 6-69 months after surgery. Routine preoperative laboratory parameters as well as tumor-specific data were assessed. Findings were compared with tumor proliferation indices, which were obtained by immunohistochemical staining for nuclear antigens Ki-67, PCNA, topoisomerase II-alpha, and p100 in paraffin embedded tumor tissue. RESULTS Univariate and multivariate statistical analyses demonstrated superiority of routine laboratory values compared with tumor proliferation indices in predicting progression-free survival and disease-specific death. The best predictor after tumor size and symptomatic presentation was ESR (P < 0.0001), with ESR values > 70 mm at 2 hours indicating a significantly poorer prognosis. Only the proliferation marker Ki-67 reached univariate significance at a threshold of 7%. CONCLUSIONS Routine laboratory parameters, such as alkaline phosphatase, lactate dehydrogenase, thrombocyte count, and especially ESR, provided superior long-term prognostic information for patients with nonmetastatic renal cell carcinoma compared with the molecular tumor proliferation markers Ki-67, PCNA, topoisomerase II-alpha, and p100.
Collapse
Affiliation(s)
- Jan Lehmann
- Department of Urology, Saarland University, Homburg/Saar, Germany.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Ito Y, Takeda T, Sasaki Y, Sakon M, Yamada T, Ishiguro S, Imaoka S, Tsujimoto M, Monden M, Matsuura N. Expression of p57/Kip2 protein in extrahepatic bile duct carcinoma and intrahepatic cholangiocellular carcinoma. LIVER 2002; 22:145-9. [PMID: 12028409 DOI: 10.1034/j.1600-0676.2002.01532.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Evaluation of the biological character of carcinomas requires understanding of cell cycle regulators. P57 (Kip2) belongs to the Cip/Kip family and is known to be one of the universal negative regulators of cell cycle. METHODS In the present study, therefore, we investigated p57 expression in 37 extrahepatic bile duct carcinomas (BDC) and 28 intrahepatic cholangiocellular carcinomas (CCC). RESULTS The average p57 labeling index (LI) in BDC and CCC were 60.8 +/- 7.9 and 58.6 +/- 18.6, respectively, which were significantly lower (p = 0.0008 and p = 0.0408, respectively) than those in normal duct epithelia (73.1 +/- 7.9, 70.4 +/- 8.2). p57 LI was significantly lower in BDC and CCC cases with biological aggressive phenotypes such as poor differentiation (p = 0.0260 and p = 0.0069), lymph node metastasis (p = 0.0274 and p = 0.0214), high Ki-67 LI (p = 0.0164 and p = 0.0343) and cyclin D1 overexpression (p = 0.0359 and p = 0.0255). CONCLUSION These findings suggest that decreased p57 expression is related to the increased activity of cell proliferation and also the progression of these carcinomas.
Collapse
Affiliation(s)
- Yasuhiro Ito
- Department of Surgery, Osaka Seamen's Insurance Hospital, 1-8-30, Chikko, Minato-ku, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Gouma DJ, Obertop H. Management of hepatobiliary and pancreatic disorders at the Academic Medical Center Amsterdam, Netherlands. HPB (Oxford) 2002; 4:35-7. [PMID: 18333150 PMCID: PMC2023910 DOI: 10.1080/136518202753598717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|