Retrospective Study
Copyright ©The Author(s) 2025.
World J Gastrointest Surg. Mar 27, 2025; 17(3): 101940
Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.101940
Table 1 Patient and tumor characteristics of the study, n (%)
Characteristics
Category
Subgroup (based on immunostaining)
Total (n = 76)
P value
Low PrPC (n = 38)
High PrPC (n = 38)
Age (years), mean ± SD66.7 ± 9.566.8 ± 9.866.7 ± 9.60.953
Male22 (57.9)27 (71.1)49 (64.5)0.338
BMI (kg/m2), mean ± SD24.4 ± 2.923.4 ± 2.723.9 ± 2.80.139
LocationHilar CCA22 (57.9)15 (39.5)37 (48.7)0.169
Intrahepatic CCA16 (42.1)23 (60.5)39 (51.3)
Tumor size (cm), mean ± SD4.1 ± 1.95.3 ± 3.54.7 ± 2.80.056
Positive LN17 (44.7)17 (44.7)34 (44.7)1.000
TNM stageI6 (15.8)5 (13.2)11 (14.5)0.890
II9 (23.7)8 (21.1)17 (22.4)
III23 (60.5)25 (65.8)48 (63.2)
Resection marginR027 (71.1)21 (55.3)48 (63.2)0.262
R111 (28.9)16 (42.1)27 (35.5)
R20 (0.0)1 (2.6)1 (1.3)
DifferentiationWD8 (21.1)12 (31.6)20 (26.3)0.177
MD25 (65.8)25 (65.8)50 (65.8)
PD5 (13.2)1 (2.6)6 (7.9)
Laboratory testsCEA (ng/dL)5.6 ± 4.411.1 ± 31.08.1 ± 21.00.406
CA19-9 (U/mL)813.7 ± 2038.11115.9 ± 2461.6957.8 ± 2237.20.591
PrPC: Cellular prion protein; BMI: Body mass index; LN: Lymph node; TNM: Tumor-node-metastasis; CCA: Cholangiocarcinoma; R0: No cancer cells seen microscopically at the primary tumor site; R1: Cancer cells present microscopically at the primary tumor site; R2: Macroscopic residual tumor at primary cancer site or regional lymph nodes; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; WD: Well-differentiated; MD: Moderately differentiated; PD: Poorly differentiated.
Table 2 Median overall survival and recurrence-free survival according to cellular prion protein expression
Characteristics
Low PrPC (n = 38)
High PrPC (n = 38)
P value
Median OS (95%CI), months137.9 (72.8-147.1)40.4 (11.2-59.1)0.041
3-year survival rate (%)28 (73.7)27 (71.1)-
5-year survival rate (%)27 (71.1)21 (55.3)-
Median RFS (95%CI), months23.8 (15.6-133.6)13.3 (7.3-31.6)0.026
3-year recurrence-free rate (%)20 (52.6)18 (47.4)-
5-year recurrence-free rate (%)19 (50.0)16 (42.1)-
PrPC: Cellular prion protein; OS: Overall survival; CI: Confidence interval; RFS: Recurrence-free survival.
Table 3 Univariate and multivariate Cox regression analyses of clinical and radiological parameters affecting overall survival in patients with resected cholangiocarcinoma
SubgroupUnivariate analysis
Multivariate analysis
HR (95%CI)
P value
aHR (95%CI)
P value
Age ≥ 65 years0.764 (0.357-1.635)0.488--
Male1.496 (0.658-3.400)0.336--
Tumor size ≥ 5 cm2.609 (1.218-5.591)0.0142.448 (1.130-5.306)0.023
LN metastasis2.222 (1.039-4.753)0.0402.633 (1.168-5.936)0.020
Resection margin2.036 (0.954-4.349)0.066--
MD tumor (WD as a reference)1.321 (0.552-3.158)0.532--
PD tumor (WD as a reference)1.073 (0.222-5.180)0.930--
CA19-9 ≥ 37 U/mL2.248 (0.954-5.296)0.064--
High PrPC2.187 (1.015-4.709)0.0462.877 (1.260-6.572)0.012
HR: Hazard ratio; CI: Confidence interval; aHR: Adjusted hazard ratio; LN: Lymph node; MD: Moderately differentiated; WD: Well-differentiated; PD: Poorly differentiated; CA19-9: Carbohydrate antigen 19-9; PrPC: Cellular prion protein.
Table 4 Univariate and multivariate Cox regression analyses of clinical and radiological parameters affecting recurrence-free survival in patients with resected cholangiocarcinoma
SubgroupUnivariate analysis
Multivariate analysis
HR (95%CI)
P value
aHR (95%CI)
P value
Age ≥ 65 years0.968 (0.510-1.840)0.921--
Male1.163 (0.617-2.193)0.641--
Tumor size ≥ 5 cm1.605 (0.816-3.157)0.170--
LN metastasis1.484 (0.803-2.746)0.208--
Resection margin1.070 (0.563-2.034)0.837--
MD tumor (WD as a reference)1.385 (0.686-2.796)0.363--
PD tumor (WD as a reference)0.290 (0.037-2.247)0.236--
CA19-9 ≥ 37 U/mL1.355 (0.724-2.534)0.342--
High PrPC1.985 (1.071-3.679)0.0291.985 (1.071-3.679)0.029
HR: Hazard ratio; CI: Confidence interval; aHR: Adjusted hazard ratio; LN: Lymph node; MD: Moderately differentiated; WD: Well-differentiated; PD: Poorly differentiated; CA19-9: Carbohydrate antigen 19-9; PrPC: Cellular prion protein.