ObjectiveTo study the abnormal biological pathways of intrahepatic cholangiocarcinoma (ICC) from the transcriptomics level and identify genes associated with the prognosis of ICC.MethodsThe differentially expressed genes were screened by t test and fold change method, then KEGG functional enrichment analysis was performed on related genes. The STRING database was applied to construct protein interaction network and find the hub nodes of the network by calculating the degree, betweenness, and closeness of each node. Kaplan-Meier survival analysis was performed using log-rank test to identify prognostic genes related to ICC.ResultsAll of 1 134 differentially expressed genes were overlapped in 3 datasets, which were mainly involved in 15 pathways, including DNA replication, cell cycle, drug metabolism, RNA transport, etc. signaling pathways and amino acid synthesis. According to protein interaction network analysis, TAF1, GRB2, E2F4, HNF4A, MYC, and TP53 genes were hub nodes. As GRB2 and TP53 genes were also the death related genes of ICC, it was found that patients with lower GRB2 gene expression had a better overall survival than those with higher GRB2 gene expression (P=0.040 9), while patients with lower TP53 had a worse overall survival than those with higher TP53 gene expression (P=0.027 3), which were also verified in the TCGA database.ConclusionsThe abnormal cell metabolism is notably related to the tumorigenesis of ICC. TAF1, GRB2, E2F4, HNF4A, MYC, and TP53 are the key genes in the carcinogenesis and progression of ICC. Expressions of GRB2 and TP53 genes are associated with the prognosis of ICC.
ObjectiveTo detect the expressions of takeda G protein-coupled receptor 5 (TGR5) and mortalin protein 75 in the tissues of patients with intrahepatic cholangiocarcinoma (ICC), and to explore their relationship with prognosis.MethodsA total of 94 ICC patients who were admitted to Anyang District Hospital and received surgical treatment from March 2015 to March 2018 were selected as the research objects. The expressions of TGR5 and mortalin protein 75 in ICC cancer tissues and adjacent tissues were detected by immunohistochemistry and Western blot (WB). The relationship between the expressions of TGR5 and mortalin protein 75 in ICC cancer tissues and clinicopathological parameters and prognosis was analyzed. Multivariate Cox proportional hazards regression was used to analyze the risk factors of poor prognosis in patients with ICC. ROC curve was used to analyze the diagnostic value of TGR5 and mortalin protein 75 for poor prognosis in patients with ICC.ResultsImmunohistochemical results showed that the positive expression rates of TGR5 and mortalin protein 75 in cancer tissues were significantly higher than those in adjacenttissues (P<0.05). WB results showed that the protein expression levels of TGR5 and mortalin protein 75 in cancer tissues were significantly higher than those in adjacent tissues (P<0.05). The expression of TGR5 protein in cancer tissues of ICC patients was correlated with gender, tumor diameter, degree of differentiation, TNM staging, satellite focus, and liver cirrhosis (P<0.05). The expression of mortalin protein 75 was correlated with tumor diameter, TNM staging, nerve involvement, satellite focus, and liver cirrhosis (P<0.05). There were significant differences in gender, tumor diameter, TNM staging, microvascular invasion, satellite focus, liver cirrhosis, and the expressions of TGR5 and mortalin protein 75 between the poor prognosis group and the good prognosis group (P<0.05). The cumulative 3-year overall survival rate of TGR5 positive patients (32.00%) was significantly lower than that of TGR5 negative patients (63.16%), χ2=6.228, P=0.013; the cumulative 3-year overall survival rate of mortalin protein 75 positive patients (32.91%) was significantly lower than that of mortalin protein 75 negative patients (66.67%), χ2=6.079, P=0.014. Multivariate Cox proportional hazards regression analysis showed that the positive expression of TGR5 and mortalin protein 75, TNM Ⅲ+Ⅳphase, satellite focus, and cirrhosis were risk factors for poor prognosis in ICC patients (P<0.05). ROC results showed that when the expression level of TGR5 was 0.932 as the cut-off value, its AUC in the diagnosis of poor prognosis of ICC patients was 0.783, the sensitivity was 72.4%, the specificity was 72.2%; when the expression level of mortalin protein 75 was 0.756 as the cut-off value, its AUC in the diagnosis of poor prognosis of ICC patients was 0.805, the sensitivity was 84.4%, the specificity was 63.9%; the AUC of combined diagnosis of TGR5 and mortalin protein 75 was 0.884, the sensitivity was 79.3%, the specificity was 83.3%.ConclusionsThe high expressions of TGR5 and mortalin protein 75 in cancer tissues of ICC patients are associated with poor prognosis, and they are risk factors for poor prognosis. The combined detection of TGR5 and mortalin protein 75 has a certain value in predicting poor prognosis, and can be used as potential biological indicators.
Objective To summarize the multi disciplinary team (MDT) discussion in the treatment of intrahepatic cholangiocarcinoma (ICC) involving inferior vena cava (IVC). Method The clinical data of a difficult ICC patient diagnosed and treated in Gansu Provincial Hospital in September 2020 were analyzed retrospectively, and the clinical features, diagnosis, treatment decision and prognosis of ICC were summarized. Results The patient was initially diagnosed as liver malignant tumor, which invaded the right adrenal gland and inferior vena cava. After MDT discussion, the patient decided to undergo surgical treatment, and successfully underwent radical resection of liver tumor combined with right adrenal gland and partial inferior vena cava and vascular reconstruction. The operation lasted 300 minutes, and the intraoperative bleeding was about 600 mL. The results of postoperative pathological examination indicated that it conformed to ICC, and carcinomatous tissues involvement could be seen in inferior vena cava and adrenal gland. The patient had no complication after operation and was discharged from hospital at 2 weeks after operation. The patient had been followed up for half a year and had been regularly treated with gemcitabine combined with platinum for 6 phases. No tumor recurrence or metastasis had been found. Conclusions The onset of ICC is concealed and its invasiveness is strong. The preliminary diagnosis can be determined by imaging examination combined with detection of tumor markers. Radical surgery is the main treatment. After MDT discussion, the formulation of a comprehensive treatment plan, including surgical strategy, local treatment and systemic treatment, can improve the prognosis and prolong the survival time of patients.