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目的探讨叉头框蛋白A2(forkhead box A2,FOXA2)在肝内胆管细胞癌(ICC)组织中的表达及其与患者预后的关系。方法回顾性收集2009-2013年期间于笔者所在医院行手术切除的85例ICC患者的临床病理资料,采用免疫组化染色法检测ICC组织中FOXA2的表达,并分析其与患者临床病理学特征及患者预后的关系。结果本组85例患者中,50例FOXA2呈高表达,35例呈低表达。ICC患者中FOXA2的表达与TNM分期相关(P<0.050),Ⅰ+Ⅱ期患者的高表达率高于Ⅲ+Ⅳ期患者。术后所有患者均获访,随访时间3~73个月,中位数为15个月。随访期间65例肿瘤复发,64例死亡。多因素分析结果表明,存在卫星灶、FOXA2低表达及CA19-9水平升高者的术后复发率更高(P<0.050),肿瘤神经侵犯、存在卫星灶、FOXA2低表达和术前CA19-9升高者的术后生存情况差(P<0.050)。结论 FOXA2呈低表达的ICC患者的预后较差,FOXA2可能是反映ICC患者预后的指标。
Objective To investigate the expression of forkhead box A2 (FOXA2) in intrahepatic cholangiocarcinoma (ICC) and its relationship with prognosis. Methods We retrospectively collected the clinicopathological data of 85 ICC patients who underwent surgical resection in the author’s hospital during the period of 2009-2013. The expression of FOXA2 in ICC tissues was detected by immunohistochemical staining, and its clinical pathological features were analyzed. The relationship between patient outcomes. Results Of the 85 patients in this group, 50 showed high expression of FOXA2 and 35 showed low expression. The expression of FOXA2 in ICC patients was associated with TNM staging (P<0.050), and the high expression rate in patients with I+II was higher than that in patients with stage III+IV. All patients were followed up for 3 to 73 months with a median of 15 months. During follow-up, 65 cases of tumor recurrence and 64 cases died. Multivariate analysis showed that the presence of satellite foci, low expression of FOXA2, and elevated CA19-9 levels had a higher postoperative recurrence rate (P<0.050), neurological invasion, presence of satellite foci, low expression of FOXA2, and preoperative CA19- Postoperative survival was poor in the 9-higher (P<0.050). Conclusion The prognosis of ICC patients with low expression of FOXA2 is poor, and FOXA2 may be an indicator reflecting the prognosis of ICC patients.