临床肿瘤学杂志

目的 分析肝内胆管癌(ICC)患者的FXYD3表达并探讨其与组织学分型及预后的关系。方法 回顾性提取245例南京鼓楼医院2014年至2024年间行根治性手术切除且术后病理证实为ICC的肿瘤样本。收集患者临床病历资料，术前血清生化指标和随访情况。依据细胞形态和组织结构等将ICC分为大胆管型与小胆管型。采用免疫组化染色法检测FXYD3在ICC组织中的表达情况。Kaplan-Meier法绘制总生存时间(OS)曲线；Cox风险比例回归模型分析影响患者OS的因素。结果 245例患者中FXYD3高表达123例，低表达组122例。在大胆管型ICC中有86.2%(81/94)FXYD3高表达，而小胆管型ICC中有27.8%(42/151)FXYD3高表达，FXYD3表达与ICC组织学分型的差异有统计学意义(χ²=78.917,P<0.001)。Kaplan-Meier结果显示，FXYD3高表达组患者5年生存率为59.3%(73/123),低于FXYD3低表达组的71.3%(87/122),差异具有统计学意义(P=0.014)。多因素Cox风险比例回归模型结果显示：FXYD3表达是影响肝内胆管癌患者OS的独立因素(HR=1.722,95%CI:1.007～2.945,P=0.047)。结论 FXYD3在大胆管型ICC中高表达且FXYD3高表达是ICC的独立预后风险因素。

Objective To analyze the expression of FXYD3 in intrahepatic cholangiocarcinoma(ICC) patients and evaluate its value in histological subtypes and prognosis. Methods A retrospective analysis was conducted on 245 tumor samples obtained from ICC patients who underwent radical surgical resection at Nanjing Drum Tower Hospital between 2014 and 2024, with postoperative pathology confirming ICC. Clinical and pathological data, preoperative serum biochemical parameters, and follow-up information were collected. Based on cellular morphology and tissue architecture, ICC was classified into large-duct and small-duct subtypes. Immunohistochemical staining was used to assess and score FXYD3 expression in ICC tumor tissues. The Kaplan-Meier method was used to draw the overall survival(OS) curve; Cox proportional hazards regression model was used to analyze the factors affecting OS of patients. Results Among 245 patients, 123 cases showed high FXYD3 expression, while 122 exhibited low expression. High FXYD3 expression was observed in 86.2%(81/94) of large-duct ICC cases, compared to 27.8%(42/151) of small-duct ICC cases, indicating a statistically significant difference in FXYD3 expression between the two histological subtypes(χ²=78.917, P<0.001). The Kaplan-Meier method showed that the 5-year survival rate of patients in the FXYD3 high expression group was 59.3%(73/123), which was lower than that in the FXYD3 low expression group(71.3%, 87/122), and the difference was statistically significant(P = 0.014).Multivariate Cox proportional hazards regression analysis identified FXYD3 expression as an independent prognostic factor for ICC patients(HR=1.722, 95% CI:1.007-2.945, P=0.047). Conclusion FXYD3 is significantly expressed in large-duct type ICC, and high FXYD3 expression is an independent prognostic risk factor for ICC.