Shibata Y, Sudo T, Tazuma S, Tanimine N, Onoe T, Shimizu Y, Yamaguchi A, Kuraoka K, Takahashi S, Tashiro H. Transmembrane serine protease 4 expression in the prognosis of radical resection for biliary tract cancer. World J Gastrointest Surg 2024; 16(8): 2555-2564 [PMID: 39220090 DOI: 10.4240/wjgs.v16.i8.2555]
Corresponding Author of This Article
Yoshiyuki Shibata, MD, Surgeon, Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama, Kure, Hiroshima 737-0023, Japan. yshibata.hiroshima@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yoshiyuki Shibata, Takeshi Sudo, Sho Tazuma, Naoki Tanimine, Takashi Onoe, Yosuke Shimizu, Hirotaka Tashiro, Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima 737-0023, Japan
Atsushi Yamaguchi, Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima 737-0023, Japan
Kazuya Kuraoka, Department of Diagnostic Pathology, National Hospital Organization Kure Medical Center, and Chugoku Cancer Center, Hiroshima 737-0023, Japan
Shinya Takahashi, Department of Surgery, Graduate School of Biochemical and Health Science, Hiroshima University, Hiroshima 734-8551, Japan
Author contributions: Shibata Y and Sudo T performed the study conception and design, data acquisition, data analysis and interpretation, drafting of the manuscript, and critical revision of the manuscript; Tazuma S, Tanimine N, Onoe T, Shimizu Y, Yamaguchi A and Tashiro H performed the data acquisition; Kuraoka K performed the data acquisition and the data analysis and interpretation; Takahashi S critically revised the manuscript.
Institutional review board statement: The protocol for this research project has been approved by a suitably constituted Ethics Committee of the institution, and it conforms to the provisions of the Declaration of Helsinki. The Institutional Review Board of National Hospital Organization Kure Medical Center approved this study (Approval No. 2023-45 on October 4, 2023).
Informed consent statement: All patients provided written informed consent.
Conflict-of-interest statement: The authors have no financial relationships to disclose.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yoshiyuki Shibata, MD, Surgeon, Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama, Kure, Hiroshima 737-0023, Japan. yshibata.hiroshima@gmail.com
Received: April 21, 2024 Revised: May 23, 2024 Accepted: June 25, 2024 Published online: August 27, 2024 Processing time: 117 Days and 9.2 Hours
Abstract
BACKGROUND
Recent advancements in biliary tract cancer (BTC) treatment have expanded beyond surgery to include adjuvant therapy, yet the prognosis remains poor. Identifying prognostic biomarkers could enhance the assessment of patients who have undergone radical resection for BTC.
AIM
To determine transmembrane serine protease 4 (TMPRSS4) utility as a prognostic biomarker of radical resection for BTC.
METHODS
Medical records of patients who underwent radical resection for BTC, excluding intrahepatic cholangiocarcinoma, were retrospectively reviewed. The associations between TMPRSS4 expression and clinicopathological factors, overall survival, and recurrence-free survival were analyzed.
RESULTS
Among the 85 patients undergoing radical resection for BTC, 46 (54%) were TMPRSS4-positive. The TMPRSS4-positive group exhibited significantly higher preoperative carbohydrate antigen 19-9 (CA19-9) values and greater lymphatic invasion than the TMPRSS4-negative group (P = 0.019 and 0.039, respectively). Postoperative overall survival and recurrence-free survival were significantly worse in the TMPRSS4-positive group (median survival time: 25.3 months vs not reached, P < 0.001; median survival time: 28.7 months vs not reached, P = 0.043, respectively). Multivariate overall survival analysis indicated TMPRSS4 positivity, pT3/T4, and resection status R1 were independently associated with poor prognosis (P = 0.032, 0.035 and 0.030, respectively). TMPRSS4 positivity correlated with preoperative CA19-9 values ≥ 37 U/mL and pathological tumor size ≥ 30 mm (P = 0.016 and 0.038, respectively).
CONCLUSION
TMPRSS4 is a potential prognostic biomarker of radical resection for BTC.
Core Tip: Transmembrane serine protease 4 (TMPRSS4) expression correlates with poor prognosis in patients with biliary tract cancer post-radical resection, indicating its potential as a prognostic biomarker. TMPRSS4 positivity is linked to higher preoperative carbohydrate antigen 19-9 levels, lymphatic invasion, and larger tumor size. This study underscores the importance of TMPRSS4 in enhancing prognostic assessment and guiding treatment strategies for patients with biliary tract cancer undergoing radical resection.
