Email updates

Keep up to date with the latest news and content from BMC Cancer and BioMed Central.

Open Access Research article

The associated expression of Maspin and Bax proteins as a potential prognostic factor in intrahepatic cholangiocarcinoma

Antonello A Romani1, Paolo Soliani2, Silvia Desenzani1, Angelo F Borghetti1* and Pellegrino Crafa3

Author Affiliations

1 Dipartimento di Medicina Sperimentale – Sezione di Patologia Molecolare ed Immunologia, Università degli Studi di Parma, 43100 Parma, Italy

2 Dipartimento di Scienze Chirurgiche – Sezione di Clinica Chirurgica Generale e dei Trapianti d'Organo, Università degli Studi di Parma, 43100 Parma, Italy

3 Dipartimento di Patologia e Medicina di Laboratorio – Sezione di Anatomia ed Istologia Patologica, Università degli Studi di Parma, 43100 Parma, Italy

For all author emails, please log on.

BMC Cancer 2006, 6:255  doi:10.1186/1471-2407-6-255

Published: 26 October 2006

Abstract

Background

Maspin, a member of the serpin family, is a suppressor of tumor growth, an inhibitor of angiogenesis and an inducer of apoptosis. Maspin induces apoptosis by increasing Bax, a member of the Bcl-2 family of apoptosis-regulating proteins. In this exploratory study, we investigated the associated expression of Maspin and Bax proteins as a potential prognostic factor in intrahepatic cholangiocarcinoma (IHCCA).

Methods

Twenty-two paraffin-embedded samples were analyzed by immunohistochemical methods using Maspin, Bax and CD34 antibodies. Maspin was scored semiquantitatively (HSCORE). Apoptosis was assessed using an antibody against cleaved caspase-3.

Results

The strong relationship observed between the expression of Maspin and Bax, indicates that Bax is likely to be the key effector of Maspin-mediated induction of apoptosis as indicated by the activation of cleaved caspase-3. We categorized Maspin HSCORE by calculating the optimal cutpoint. A Maspin HSCORE above the cutpoint was inversely related with tumor dimension, depth of tumor and vascular invasion. Uni/multivariate analysis suggests that a Maspin HSCORE below the cutpoint significantly worsens the patients' prognosis. Tumors with Maspin HSCORE below the cutpoint had a shorter survival (11+/-5 months) than did patients with Maspin HSCORE above the cutpoint (27+/-4 months), whereas Kaplan-Meier analysis and logrank test showed no significant difference in overall survival between the patients.

Conclusion

The associated expression of Maspin and Bax might delay tumor progression in IHCCA. Maspin above the cutpoint might counteract tumor development by increasing cell apoptosis, and by decreasing tumor mass and cell invasion. The combined expression of Maspin and Bax appears to influence the susceptibility of tumor cholangiocytes to apoptosis and thus may be involved in delaying IHCCA progression.