肝内胆管癌中成纤维细胞生长因子受体2表达及临床意义  

Expression and clinical significance of fibroblast growth factor receptor 2 in intrahepatic cholangiocarcinoma

作　　者：沈建军 韩惠娟 张丽娜 王增悦 王逢春 SHEN Jianjun;HAN Huijuan;ZHANG Lina;WANG Zengyue;WANG Fengchun(Department of Clinical Laboratory,962 Hospital of Joint Logistics Support Force,Harbin 150080,China)

机构地区：[1]联勤保障部队第九六二医院检验科,哈尔滨150080 [2]联勤保障部队第九六二医院肿瘤科,150080 [3]联勤保障部队第九六二医院普通外科,150080

出　　处：《临床肿瘤学杂志》2024年第11期1089-1094,共6页Chinese Clinical Oncology

摘　　要：目的探讨肝内胆管癌(iCCA)组织中成纤维细胞生长因子受体(FGFR)2表达及其临床意义。方法收集2018年1月至2022年12月在联勤保障部队第九六二医院接受肝切除术的201例iCCA福尔马林固定石蜡包埋(FFPE)标本。另收集肝内胆管扩张(IHBD)13例和胆管上皮内瘤变34例[低级别胆道上皮内瘤变(BilIN-1/2)23例和高级别胆道上皮内瘤变(BilIN-3)11例]组织,检测各组FGFR2表达。采用受试者特征工作曲线(ROC)分析FGFR2表达诊断iCCA的效能。Kaplan-miere法绘制复发时间(TTR)和总生存时间(OS)曲线,生存差异行Log-rank检验。采用多因素Cox风险比例回归模型分析影响iCCA患者TTR的因素。结果iCCA、IHBD、BilIN-1/2、BilIN-3组织中FGFR2表达HScore分别为8.51(1.44,38.40)、0(0,7.82)、1.16(0,4.0)、1.32(0,4.43),iCCA组FGFR2表达水平显著高于其他组(P<0.05)。ROC曲线显示组织FGFR2表达水平具有良好的鉴别诊断iCCA的效能(P<0.05),曲线下面积(AUC)>0.7。多因素Cox风险比例回归模型分析发现肿瘤直径、FGFR2表达、TNM分期都是影响iCCA患者TTR的独立因素(P<0.05)。Kaplan-Meier法显示,FGFR2高表达患者术后中位TTR(5.60个月vs.9.90个月,P<0.001)和中位OS(18.00个月vs.19.10个月,P=0.048)均较FGFR2低表达患者短。结论FGFR2有助于鉴别良性胆管疾病和iCCA,FGFR2的高表达提示iCCA患者预后不良。Objective To investigate the expression and clinical significance of fibroblast growth factor receptor(FGFR)2 in intrahepatic cholangiocarcinoma(iCCA)tissues.Methods Two hundred and one iCCA formalin fixed paraffin embedded(FFPE)specimens that underwent liver resection at the 962 Hospital of the Joint Logistics Support Force from January 2018 to December 2022 were collected.In addition,13 cases of intrahepatic bile duct dilation(IHBD)and 34 cases of biliary epithelial neoplasia[23 cases of low-grade biliary epithelial neoplasia(BilIN-1/2)and 11 cases of high-grade biliary epithelial neoplasia(BilIN-3)]tissues were collected to detect FGFR2 expression in each group.The efficacy of FGFR2 expression in diagnosing iCCA was analyzed using receiver operating characteristic curve(ROC)analysis.Kaplan-meier method was used to plot the recurrence time(TTR)and overall survival time(OS)curves,and survival differences were analyzed using Log rank test.Using a multiple factor Cox proportional hazards regression model to analyze the influencing factors of TTR in iCCA patients.Results The HScore of FGFR2 expression in iCCA,IHBD,BilIN-1/2,and BilIN-3 tissues were 8.51(1.44,38.40),0(0,7.82),1.16(0,4.0),and 1.32(0,4.43),respectively.The FGFR2 expression level in the iCCA group was significantly higher than that in the other three groups(P<0.05).The ROC curve shows that the expression level of FGFR2 in tissues has good diagnostic efficacy for iCCA(P<0.05),and the area under the curve(AUC)is higher than 0.7.Multivariate Cox proportional hazards regression model analysis found that tumor diameter,FGFR2 expression,and TNM staging were independent prognostic factors affecting TTR in iCCA patients(P<0.05).Kaplan-Meier method showed that patients with high FGFR2 expression had shorter postoperative median TTR(5.60 months vs.9.90 months,P<0.001)and median OS(18.00 months vs.19.10 months,P=0.048)than the patients with low FGFR2 expression.Conclusion FGFR2 is helpful in distinguishing benign biliary diseases from iCCA,and high expression of

关 键 词：肝内胆管癌 免疫组化染色 生物标志物 术后复发 成纤维细胞生长因子受体2 诊断 

分 类 号：R735.7[医药卫生—肿瘤]