2012 ©
             Publication
Journal Publication
Title of Article High Levels of Serum IgG for Opisthorchis viverrini and CD44 Expression Predict Worse Prognosis for Cholangiocarcinoma Patients after Curative Resection 
Date of Acceptance 29 April 2021 
Journal
     Title of Journal International Journal of General Medicine 
     Standard SCOPUS 
     Institute of Journal https://www.dovepress.com/international-journal-of-general-medicine-journal 
     ISBN/ISSN https://doi.org/10.2147/IJGM.S306339 
     Volume 2021 
     Issue 14 
     Month june
     Year of Publication 2021 
     Page 2191—2204 
     Abstract Background: Opisthorchis viverrini (OV)-associated cholangiocarcinoma (CCA) has a high immune response with chronic inflammation and oxidative stress. CD44 and Nestin, two cancer stem cell (CSC) markers, play major roles in cancer cell survival. Effects of immune response and expression CSC markers on survival of patients with CCA remain unclear. Objective: To investigate the effects of level of OV IgG together with CSC marker expression and also the combination of these markers on survival of CCA patients after curative resection. Methods: All serum specimens from CCA patients who underwent curative surgery from 2005 to 2015 were examined for IgG for OV antigen by ELISA. Tissue specimens were studied for CD44 and Nestin expression. Survival analysis by Cox proportional hazard model was used for estimating hazard ratio (HR) with a 95% confidence interval (CI). Results: In this study, 122 (69.3%) of 176 were positive for OV IgG, and 35 (19.9%) were considered to have high-positive OV IgG. CD44s positive expression was found in 54 (40%), CD44v6 high expression in 96 (69.6%), CD44v8-10 high expression in 87 (63.5%) and Nestin high expression in 21 (16.1%). Multivariate survival analysis found that high-positive OV IgG and late stage tumor were independent prognostic factors with the adjusted HR of 2.24 (95% CI 1.27– 3.93) and 2.78 (95% CI 1.46– 5.29), respectively. Subgroup analysis in early and late stage CCA showed that a combined positive OV IgG and CD44s expression with the high expression of CD44v8-10 had the significantly poorest prognosis with HR of 3.75 (95% CI 1.61– 8.72) and HR of 1.76 (95% CI 1.02– 3.03), respectively. Conclusion: A high level of OV IgG as well as a high level of CSC markers resulted in an aggressive CCA. OV IgG level together with CSC markers can be used as the prognostic markers for CCA patients’ survival. The study of the CD44 pathway is promising for adjuvant treatment. 
     Keyword CCA, OV‐associated CCA, survival, OV IgG antibody, CD44s, CD44v8-10 
Author
607110016-6 Mr. ATTAPOL TITAPUN [Main Author]
Public Health Doctoral Degree

Reviewing Status มีผู้ประเมินอิสระ 
Status ตีพิมพ์แล้ว 
Level of Publication นานาชาติ 
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