转录信号传导子及激活子3在肝内胆管癌中的表达及意义

目的 检测转录信号传导子及激活子3（STAT3）在肝内胆管癌（ICC）中的表达情况，并分析STAT3表达对手术切除后的临床效果及预后的影响。方法 采用免疫组织化学法检测ICC组织中STAT3的表达，并分析STAT3表达与临床病理参数之间的关系；采用Pearson χ2检验和Fisher精确检验分析STAT3表达与其他临床病理参数的关系；采用Kaplan-Meier（KM）法估计和绘制生存曲线，采用log-rank检验进行组间生存曲线的比较；采用Cox危险度回归模型分析临床病理参数和STAT3表达对生存率的影响。结果 ICC组织中STAT3表达较瘤旁组织增加，且与肿瘤体积大、病理性卫星灶、微血管侵犯、肿瘤分化差以及淋巴结转移密切相关。高表达STAT3患者的总体生存期和无瘤生存期更短，预后更差。Cox多因素分析结果发现STAT3高表达是影响总体生存期的独立预后因素。结论 STAT3高表达提示预后较差，是ICC患者预后的独立影响因素，可能成为ICC靶向治疗的潜在靶点。
Objective To determine the expression of signal transducers and activators of transcription 3 (STAT3) in intrahepatic cholangiocarcinoma (ICC) and to evaluate its influence on the outcome and prognosis of patients. Methods The expression of STAT3 was examined in intrahepatic cholangiocarcinoma (ICC) by immunohistochemistry assays. The correlation between STAT3 expression and clinicopathological parameters was analyzed by Pearson χ2 test and Fisher's exact test. Kaplan-Meier (KM) method was used to estimate and draw the survival curves, and the log-rank test was employed to compare the survival curves between groups. The effects of clinicopathological parameters and STAT3 expression on survival rate of patients were analyzed by Cox regression model. Results The expression of STAT3 in ICC tumor tissues was higher than that in peritumoral tissues, and was closely correlated with the tumor size, pathological satellite, microvascular invasion, undifferentiated-type histology and lymph node metastasis. Patients with high STAT3 expression had a poor prognosis with respect to overall survival (OS) and disease-free survival (DFS). The Cox multivariate survival analysis indicated that STAT3 was an independent prognostic factor for OS. Conclusion High STAT3 expression in ICC is correlated with worse surgical outcomes and it is an independent factor of prognosis, and may also serve as a potential target for treatment of ICC