Abstract
Purpose: To analyze the preoperative serum matrix metalloproteinase-9 (MMP-9) levels and prognosis of patients with hilar cholangiocarcinoma (HC) undergoing radical resection. Methods: Preoperative serum MMP-9 levels in patients with HC undergoing radical resection were detected by enzyme-linked immunosorbent assay (ELISA). The ROC curve assay was used to analyze the preoperative serum MMP-9 level to determine the most valuable cut-off point. The relationship between MMP-9 and clinicopathological features of HC patients was analyzed. Kaplan-Meier method was used to analyze the prognostic factors, and COX regression model was used to analyze the independent risk factors affecting prognosis. Results: Preoperative serum MMP-9 levels were significantly elevated in the death patients compared with the survival patients. The most valuable cut-off point for preoperative serum MMP-9 for prognosis was 201.93 ng/mL. Preoperative serum MMP-9 was associated with Bismuth-Corlette classification) and lymph node metastasis. Kaplan-Meier analysis showed that MMP-9, Bismuth-Corlette classification, Lymph node metastasis, Portal vein invasion, Hepatic artery invasion, Liver invasion, Incised margin, and Preoperative biliary drainage were related to prognosis. Cox regression model confirmed that hepatic artery invasion, liver invasion, incised margin, and MMP-9 have the potential to independence predicate prognosis in HC patients. Conclusion: Preoperative serum MMP-9 has high predictive value for prognosis and is an independent influencing factor for the prognosis of patients with hilar cholangiocarcinoma.
Highlights
Hilar cholangiocarcinoma (HC), known as Klatskin tumor, is a malignant tumor that grows in the confluence of the left and right hepatic ducts and the common hepatic duct
We found that the area under the receiver operating characteristic curve (ROC) curve of serum MMP-9 levels predicting patient mortality was 0.896 (Fig. 3), confirming that preoperative serum MMP-9 has a higher value in predicting postoperative prognosis in HC patients
We found that preoperative serum MMP-9 levels were associated with Bismuth-Corlette classification and Lymph node metastasis, which may be related to the lower sensitivity of MMP-9 in predicting the prognosis of HC patients
Summary
Hilar cholangiocarcinoma (HC), known as Klatskin tumor, is a malignant tumor that grows in the confluence of the left and right hepatic ducts and the common hepatic duct. Liver resection and liver transplantation in HC patients are currently the only radical surgery[3], only a small number of patients still have the opportunity to undergo radical surgery after diagnosis, and the postoperative prognosis is poor. Other adjuvant therapies such as chemotherapy and radiotherapy have not achieved satisfactory results in improving the prognosis of patients[4]. Studying factors related to prognosis after surgical treatment and finding related markers for preventing HC recurrence or metastasis are of great significance for improving the longterm survival of HC patients
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