CD24 expression predicts distant metastasis in extrahepatic bile duct cancer
CD24 expression predicts distant metastasis in extrahepatic bile duct cancer
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DOI：
10.3748/wjg.v19.i9.1438
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发表时间：
2013-03-07
影响因子：
4.3
通讯作者：
Ha, Sung W.
中科院分区：
文献类型：
--
作者：
Kim, Kyubo;Min, Hye Sook;Ha, Sung W.
目的：评估CD 24表达在肝外胆管癌（EHBD）患者接受辅助放化疗中的预后意义。方法：84例EHBD癌患者接受根治性切除术后接受辅助放化疗。术后放疗的肿瘤床和区域淋巴结的中位数为40戈伊（范围：40-56戈伊）。所有患者在放射治疗期间还接受了氟嘧啶化疗增敏。组织芯片免疫组化染色检测CD 24表达。多因素分析结果显示：36例（42.9%）患者CD 24表达阳性，其中36例（42.9%）患者CD 24表达阳性，CD 24表达阳性的患者CD 24表达阳性。CD 24表达与远处转移有关，但与局部复发和总生存率无关。阴性表达和阳性表达患者的5年无远处转移生存率分别为55.1%和29.0%（P = 0.0100）。多因素分析显示，N分期、组织学分化程度和CD 24表达是无远处转移生存率的唯一显著性因素（P = 0.0089），而CD 24表达具有边缘性意义（P = 0.0733）。在亚组分析中，CD 24表达与淋巴结阳性患者的5年无远处转移生存率显著相关（38.4%阴性表达vs 0%阳性表达，P = 0.0110），但在淋巴结阴性患者中并非如此（62.0%vs64.0%，P = 0.8599）。CD 24表达是接受根治性切除术后辅助放化疗的患者远处转移的重要预测因子尤其是对于淋巴结阳性的EHBD癌症。(C)2013年百世登。All rights reserved.
AIM: To evaluate the prognostic significance of CD24 expression in patients undergoing adjuvant chemoradiotherapy for extrahepatic bile duct (EHBD) cancer.METHODS: Eighty-four patients with EHBD cancer who underwent curative resection followed by adjuvant chemoradiotherapy were enrolled in this study. Postoperative radiotherapy was delivered to the tumor bed and regional lymph nodes up to a median of 40 Gy (range: 40-56 Gy). All patients also received fluoropyrimidine chemotherapy for radiosensitization during radiotherapy. CD24 expression was assessed with immunohistochemical staining on tissue microarray. Clinicopathologic factors as well as CD24 expression were evaluated in multivariate analysis for clinical outcomes including loco-regional recurrence, distant metastasis-free and overall survival.RESULTS: CD24 was expressed in 36 patients (42.9%). CD24 expression was associated with distant metastasis, but not with loco-regional recurrence nor with overall survival. The 5-year distant metastasis-free survival rates were 55.1% and 29.0% in patients with negative and positive expression, respectively (P = 0.0100). On multivariate analysis incorporating N stage, histologic differentiation and CD24 expression, N stage was the only significant factor predicting distant metastasis-free survival (P = 0.0089), while CD24 expression had borderline significance (P = 0.0733). In subgroup analysis, CD24 expression was significantly associated with 5-year distant metastasis-free survival in node-positive patients (38.4% with negative expression vs 0% with positive expression, P = 0.0110), but not in node-negative patients (62.0% with negative expression vs 64.0% with positive expression, P = 0.8599).CONCLUSION: CD24 expression was a significant predictor of distant metastasis for patients undergoing curative resection followed by adjuvant chemoradiotherapy especially for node-positive EHBD cancer. (C) 2013 Baishideng. All rights reserved.