Abstract
Autophagy can be tumor suppressive as well as promotive in regulation of tumorigenesis and disease progression. Accordingly, the prognostic significance of autophagy key regulator Beclin 1 was varied among different tumors. Here, we detected the clinicopathological and prognostic effect of Beclin 1 in the subtypes of intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC). Beclin 1 expression level was detected by immunohistochemistry staining in 106 ICC and 74 ECC patients. We found that Beclin 1 was lowly expressed in 126 (70%) cholangiocarcinoma patients, consist of 72 ICC and 54 ECC. Moreover, the cholangiocarcinoma patients with lymph node metastasis (N1) had a lower Beclin 1 level than that of N0 subgroup (P=0.012). However, we did not detect any correlations between Beclin 1 and other clinicopathological features, including tumor subtypes, vascular invasion, HBV infection, liver cirrhosis, cholecystolithiasis and TNM stage. Survival analysis showed that, compared with the high expression subset, Beclin 1 low expression was correlated with a poorer 3-year progression-free survival (PFS, 69.1% VS 46.8%, P=041) for cholangiocarcinoma. Importantly, our stratified univariate and multivariate analysis confirmed that Beclin 1 lowly expressed ICC had an inferior PFS as well as overall survival than ECC, particularly than that of Beclin 1 highly expressed ECC patients. Thus, our study demonstrated that Beclin 1low expression, correlated with lymph node metastasis, and might be a negative prognostic biomarker for cholangiocarcinoma. Combined Beclin 1 level with the anatomical location might lead to refined prognosis for the subtypes of ICC and ECC.
Highlights
Cholangiocarcinoma is a malignant neoplasm in the biliary duct system accounts for 10-25% of primary hepatic tumor and represents 3% of gastrointestinal cancer worldwide [1,2]
We found that Beclin 1 was lowly expressed in cholangiocarcinoma, and correlated with lymph node metastasis
Patient characteristics and Beclin 1 expression A total of 180 patients, including of 106 intrahepatic cholangiocarcinoma (ICC) and 74 extrahepatic cholangiocarcinoma (ECC), that received cholangiocarcinoma resection surgery were recruited in this study
Summary
Cholangiocarcinoma is a malignant neoplasm in the biliary duct system accounts for 10-25% of primary hepatic tumor and represents 3% of gastrointestinal cancer worldwide [1,2].
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