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Peritumoral SPARC expression and patient outcome with resectable intrahepatic cholangiocarcinoma
Chi-Tung Cheng1, Yin-Yi Chu2, Chun-Nan Yeh1
1Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Background And Objectives:
Cholangiocarcinoma (CCA) affects thousands worldwide with increasing incidence. SPARC (secreted protein acidic and rich in cysteine) plays an important role in cellular matrix interactions, wound repair, and cellular migration, and has been reported to prevent malignancy from growth. SPARC undergoes epigenetic silencing in pancreatic malignancy, but is frequently expressed by stromal fibroblasts adjacent to infiltrating pancreatic adenocarcinomas. CCA is also a desmoplastic tumor, similar to pancreatic adenocarcinoma. SPARC's clinical influence on clinicopathological characteristics of mass-forming (MF)-CCA still remains unclear. In this study, we evaluate the expression of SPARC in tumor and stromal tissue to clarity its relation with prognosis.
Methods:
Seventy-eight MF-CCA patients who underwent hepatectomy with curative intent were enrolled for an immunohistochemical study of SPARC. The expression of immunostaining of SPARC was characterized for both tumor and stromal tissues. We conducted survival analysis with 16 clinicopathological variables. The overall survival (OS) was analyzed by Kaplan-Meier analysis and Cox proportional hazards regression modeling.
Results:
Thirty-three men and 45 women with MF-CCA were studied. Within total 78 subjects, 12 (15.4%) were classified as tumor negative/stroma negative, 37 (47.4%) as tumor positive/stroma negative, four (5.1%) as tumor negative/stroma positive, and 25 (32.1%) as tumor positive/stroma positive. With a median follow-up of 13.6 months, the 5-year OS was 14.9%. Cox proportional hazard analysis revealed that SPARC tumor positive and stromal negative immunostaining and curative hepatectomy predicted favorable OS in patients with MF-CCA after hepatectomy.
Conclusion:
MF-CCA patients with SPARC tumor positive and stromal negative expression may have favorable OS rates after curative hepatectomy.
Insights
Secreted protein acidic and rich in cysteine (SPARC) expression in mass-forming cholangiocarcinoma (MF-CCA) impacts patient outcomes. Tumor-positive and stroma-negative SPARC indicates a favorable prognosis after curative hepatectomy for MF-CCA.
Area of Science:
- Oncology
- Cancer Biology
- Surgical Oncology
Background:
- Cholangiocarcinoma (CCA) incidence is rising globally.
- SPARC (secreted protein acidic and rich in cysteine) influences matrix interactions and may inhibit malignancy.
- CCA is a desmoplastic tumor, and SPARC's role in mass-forming CCA (MF-CCA) prognosis is unclear.
Purpose of the Study:
- To evaluate SPARC expression in tumor and stromal tissues of MF-CCA patients.
- To clarify the relationship between SPARC expression and clinicopathological characteristics and prognosis.
Main Methods:
- Immunohistochemical analysis of SPARC in tumor and stromal tissues from 78 MF-CCA patients undergoing curative hepatectomy.
- Survival analysis using Kaplan-Meier and Cox proportional hazards regression with 16 clinicopathological variables.
Main Results:
- SPARC expression varied: 15.4% tumor-/stroma-, 47.4% tumor+/stroma-, 5.1% tumor-/stroma+, and 32.1% tumor+/stroma+.
- Median follow-up was 13.6 months; 5-year overall survival (OS) was 14.9%.
- SPARC tumor-positive/stroma-negative expression and curative hepatectomy were associated with favorable OS.
Conclusions:
- MF-CCA patients with SPARC tumor-positive and stromal-negative expression may experience improved OS after curative hepatectomy.
- SPARC expression patterns could serve as a prognostic biomarker in MF-CCA.
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