An Immunohistochemical Study of Tumor Vascularity and Proliferation Activity in Cholangiocellular Carcinoma: Relationship to Clinicopathologic Factors and Prognosis after Hepatic Resection

This study was designed to provide an immunohistochemical analysis of tumor biological factors in 28 patients who underwent hepatectomy for cholangiocellular carcinoma (CCC). Analyzed factors were microvessel counts (stained by CD34) and proliferating cell nuclear antigen (PCNA). PCNA L.I. was correlated with serum level of CA19-9, which was correlated with a higher recurrence rate and shorter patient survivals. Microvessel counts were negatively correlated with tumor size. Furthermore, the microvessel count in CCC with mass-forming (MF) plus periductal infiltrating (PI) type associated with poorer survivals, was significantly lower compared to that of CCC with MF type or PI type. Neither microvessel counts nor PCNA L.I. were associated with any other clinicopathologic factors or cancer recurrence. The five-year overall and cancer-free survival rates were 26% and 13%, respectively. Patients with MF plus PI type, poorer differentiated carcinoma, stage 4A and higher CA19-9 level had shorter cancer-free and overall survivals after hepatectomy (p