Role of CD15 expression in dysplastic and neoplastic tissue of the bile duct - a potential novel tool for differential diagnosis of indeterminate biliary stricture
Role of CD15 expression in dysplastic and neoplastic tissue of the bile duct - a potential novel tool for differential diagnosis of indeterminate biliary stricture
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DOI：
10.1111/his.13041
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发表时间：
2016-12-01
期刊：
影响因子：
6.4
通讯作者：
Hartmann, Sylvia
中科院分区：
文献类型：
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作者：
Walter, Dirk;Herrmann, Eva;Hartmann, Sylvia
背景和目的CD15由多种癌症类型表达；其中包括肝内胆管癌和肝门周围胆管癌（CCA）。本研究的目的是阐明远端 CCA 以及发育不良胆管组织中的 CD15 表达，并确定其预后意义。 方法和结果对 2010 年至 2015 年间接受手术切除的肝内 (iCCA，n = 22)、肝门周围 (pCCA，n = 7) 和远端 CCA (dCCA，n = 15) 患者的组织样本进行了评估用于 CD15 表达。同时评估淋巴结转移组织 (n = 13)、CCA 相关不典型增生 (n = 20)、导管内活检中的不典型增生 (n = 10) 和良性增殖 (n = 12)，以及炎性胆管病变 (n = 28) 和非炎性胆管 (n = 23) 的 CD15 表达。 CD15被发现在iCCA（81.8％）、pCCA（85.7％）、dCCA（73.3％）、CCA相关的不典型增生（70.0％）、导管内活检中的不典型增生（100％）和转移组织（84.6％）中高表达。 64 例良性胆管改变中有 58 例 CD15 表达呈阴性，导致 CCA 中 CD15 的总体敏感性和特异性分别为 80.7% 和 90.6% 的患者。 CD15 表达与 CD15 阳性 CCA 相关不典型增生患者的总生存期下降显着相关 (P = 0.003)。然而，浸润性肿瘤成分中CD15的表达与临床结果不相关。结论CD15是胆管上皮内和浸润性肿瘤的敏感且特异的标志物。因此，它有助于从非肿瘤组织中区分发育不良和肿瘤性胆管细胞，这经常导致不确定性胆管狭窄的诊断问题。
Background and aimsCD15 is expressed by various cancer types; among these are intrahepatic and perihilar cholangiocarcinoma (CCA). The aim of this study was to elucidate CD15 expression in distal CCA as well as in dysplastic biliary tissue and to determine its prognostic significance.Methods and resultsTissue samples from patients with intrahepatic (iCCA, n = 22), perihilar (pCCA, n = 7) and distal CCA (dCCA, n = 15), who underwent surgical resection in the period from 2010 to 2015 were evaluated for CD15 expression. Tissue of synchronous lymph node metastasis (n = 13), CCA-associated dysplasia (n = 20), dysplasia in intraductal biopsies (n = 10) and benign proliferations (n = 12), as well as inflammatory biliary lesions (n = 28) and non-inflammatory bile ducts (n = 23), were evaluated equally for CD15 expression. CD15 was found to be expressed highly in iCCA (81.8%), pCCA (85.7%), dCCA (73.3%), CCA-associated dysplasia (70.0%), dysplasia in intraductal biopsies (100%) and metastatic tissue (84.6%). CD15 expression was negative in 58 of 64 benign bile duct alterations resulting in an overall sensitivity and specificity of CD15 in CCA of 80.7 and 90.6% patients, respectively. CD15 expression was correlated significantly with a decreased overall survival in patients with CD15-positive CCA associated dysplasia (P = 0.003). However, CD15 expression in the invasive tumour component was not correlated with clinical outcome.ConclusionCD15 is a sensitive and specific marker for intraepithelial and invasive neoplasias of the bile duct. Therefore, it can be helpful in the delineation of dysplastic and neoplastic biliary cells from non-neoplastic tissue, which frequently causes a diagnostic problem in indeterminate biliary stricture.