The expressions of HMGA2 and Thy1 in extrahepatic cholangiocarcinoma and their clinicopathological significances.

AIMS:Extrahepatic cholangiocarcinoma is a malignant tumor and poor prognosis with intrinsic resistance to cytotoxic agents. The molecular mechanism associated with high malignancy and resistance to chemotherapy and radiotherapy has not been fully elucidated. This study aims to investigate the clinicopathological significances of HMGA2 and Thy1 expression in extrahepatic cholangiocarcinoma. METHODS:The expressions of HMGA2 and Thy1 in 100 extrahepatic cholangiocarcinoma, 30 peritumoral tissues, 10 adenoma and 15 normal biliary tract tissues were assayed using EnVision immunohistochemistry. RESULTS:The HMGA2 and Thy1 proteins were overexpression in extrahepatic cholangiocarcinoma compared to peritumoral tissues, adenoma, and normal biliary tract tissues (P < 0.05 or P < 0.01). Adenoma and pericancerous tissues with positive HMGA2 or/and Thy1 protein expression exhibited atypical hyperplasia. The positive correlation was found between the expression of HMGA2 and Thy1 in extrahepatic cholangiocarcinoma (P < 0.01). The positive rates of HMGA2 and Thy1 expression were significantly higher in cases with poor differentiation, lymph node metastasis, invasion, and TNM stage III or IV and no resection (biopsy only) (P < 0.05 or P < 0.01). Kaplan-Meier survival analysis showed that the survival of extrahepatic cholangiocarcinoma patients with positive HMGA2 and/or Thy1 expression is significantly shorter than patients with negative HMGA2 and/or Thy1 expression (P = 0.000). Cox multivariate analysis revealed that positive HMGA2 and/or Thy1 expressions were independently poor prognosis factors in extrahepatic cholangiocarcinoma patients. We calculated the AUC for HMGA2 (AUC = 0.610, 95%CI: 0.519-0.702), or Thy1 (AUC = 0.675, 95%CI: 0.588-0.762), respectively. CONCLUSIONS:The present study indicated that positive HMGA2 and Thy1 expression are closely associated with the pathogenesis, clinical, pathological and biological behaviors, and poor prognosis in patients with extrahepatic cholangiocarcinoma.

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