Current research in perineural invasion of cholangiocarcinoma

Studies were identified by searching MEDLINE and PubMed databases for articles from January 1990 to December 2009, using the keywords "cholangiocarcinoma," "perineural invasion," "nerve growth factor"(NGF), "neural cell adhesion molecule" (NCAM), "matrix metalloproteinase"(MMP), "neurotransmitter," "acetylcholine" (Ach), and "transforming growth factor" (TGF)." Additional papers and book chapters were identified by a manual search of references from the key articles.From above we found that the molecules NGF, NCAM, MMP, Ach and TGF may have prognostic significance in, and offer clues to the mechanism of CCA neural invasion.Cholangiocarcinoma's increasing worldwide incidence is especially poignant in view of both the lacking effective therapies, and the fact that it is commonly diagnosed in advanced stages. As CCA neural invasion often appears early, more complete characterization of its molecular pathology could lead to the identification of targets for the diagnosis and therapy of this devastating malignancy.Cholangiocarcinoma (CCA) is a malignant tumor originating from biliary tract epithelial cells. Among primary liver tumors, CCA incidence is only less than that of liver cancer[1,2], and it is becoming the most common hepatic tumor-induced death[3].Due to its difficulty of diagnosis and high fatality rate, cholangiocarcinoma is extremely destructive, currently surgery is the only therapeutic mode offering a cure. Moreover, the post-resection recurrence rate is extremely high and the five-year survival rate is only 5%, at the same time, this survival rate had not vastly improved in past three decades[4]. In recent years, its worldwide morbidity and mortality have increased rapidly. Invasion delitescence, insufficient markers for early diagnosis marker, insensitivity to regular radio- and chemotherapy--these are all causes of poor prognoses of CCA patients[5,6].Cholangiocarcinoma via perineural invasion is an extremely part during its genesis and development espec