High cellular prion protein expression in cholangiocarcinoma: A marker for early postoperative recurrence and unfavorable prognosis

초록

BACKGROUND The cellular prion protein (PrPC), traditionally associated with neurodegenerative disorders, plays an important role in cancer progression and metastasis by inhibiting apoptosis. AIM To investigate the influence of PrPC expression in cholangiocarcinoma (CCA) on patient outcomes following surgical resection. METHODS Patients who underwent curative surgical resection for either intrahepatic or hilar CCA were enrolled in this retrospective study. Based on the immunohistochemical staining results of the surgical specimens, patients were categorized into two groups: The low PrPC group (negative or 1+) and the high PrPC group (2+ or 3+). Survival analyses, including overall survival and recurrence-free survival, were conducted using the Kaplan-Meier method and compared using the log-rank test. RESULTS In total, seventy-six patients diagnosed with CCA (39 with intrahepatic and 37 with hilar CCA) underwent curative hepatectomy from January 2011 to November 2021. Among these patients, 38 (50%) demonstrated high PrPC expression, whereas the remaining 38 (50%) showed low expression of PrPC. During a median follow-up period of 31.2 months (range: 1 to 137 months), the high PrPC group had a significantly shorter median overall survival than the low PrPC group (40.4 months vs 137.9 months, respectively; P = 0.041). Moreover, the high PrPC group had a significantly shorter median recurrence-free survival than the low PrPC group (13.3 months vs 23.8 months, respectively; P = 0.026). CONCLUSION PrPC expression is significantly associated with early recurrence and decreased survival period in CCA patients following surgical resection. Thus, PrPC may be used as a prognostic factor in treatment planning.

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