Association of α-SMA/FAP-positive cancer-associated fibroblasts with clinicopathological features and prognosis in extrahepatic cholangiocarcinoma

Abstract Objective This study aimed to evaluate the value of cancer-associated fibroblasts (CAFs) that positively express α-smooth muscle actin (α-SMA) and fibroblast activation protein (FAP) as survival indicators for patients with extrahepatic cholangiocarcinoma (eCCA). Methods The clinicopatholog...

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Main Authors: Xiaojun Sui, Zhangqiang Zheng, Lei Yang, Dapeng Zhang, Xiangyu Sun, Ximo Wang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Diagnostic Pathology
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Online Access:https://doi.org/10.1186/s13000-025-01691-6
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author Xiaojun Sui
Zhangqiang Zheng
Lei Yang
Dapeng Zhang
Xiangyu Sun
Ximo Wang
author_facet Xiaojun Sui
Zhangqiang Zheng
Lei Yang
Dapeng Zhang
Xiangyu Sun
Ximo Wang
author_sort Xiaojun Sui
collection DOAJ
description Abstract Objective This study aimed to evaluate the value of cancer-associated fibroblasts (CAFs) that positively express α-smooth muscle actin (α-SMA) and fibroblast activation protein (FAP) as survival indicators for patients with extrahepatic cholangiocarcinoma (eCCA). Methods The clinicopathological data of eCCA patients who underwent surgical treatment in Tianjin Nankai Hospital from January 1, 2019, to December 31, 2022, were retrospectively analysed. A total of 79 patients were included, 49 were male and 30 were female, with an age of (64.3 ± 8.3) years. Clinicopathological data such as age, gender, tumour location, lymph node metastasis, tumour differentiation degree, and TNM stage of the patients were recorded. The expressions of α-SMA and FAP, the markers of CAFs, in eCCA were detected by immunohistochemistry. The relationships between the expressions of the two proteins and the clinicopathological data and prognosis of the patients were analysed. Results The positive expressions of α-SMA and FAP in CAFs were observed in 78.5% (62/79) and 35.4% (28/79) of the patients, respectively. There was a highly positive correlation between the expression of α-SMA and that of FAP (r = 0.992, P < 0.001). Univariate analysis showed that CAFs with positive FAP expression and tumour location were statistically significant in terms of overall survival time and recurrence-free survival time. Multivariate analysis indicated that positive FAP expression and tumour location might be independent factors affecting overall survival time and recurrence-free survival time. Conclusions CAFs with positive FAP expression may be a prognostic indicator of poor postoperative survival in eCCA patients and may serve as an independent predictor of poor postoperative survival rate in these patients.
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spelling doaj-art-5fca4881eff44e48a18b649a1d1dc56f2025-08-20T04:01:42ZengBMCDiagnostic Pathology1746-15962025-07-0120111010.1186/s13000-025-01691-6Association of α-SMA/FAP-positive cancer-associated fibroblasts with clinicopathological features and prognosis in extrahepatic cholangiocarcinomaXiaojun Sui0Zhangqiang Zheng1Lei Yang2Dapeng Zhang3Xiangyu Sun4Ximo Wang5Tianjin Nankai Hospital, Tianjin Medical UniversityTianjin Nankai Hospital, Tianjin Medical UniversityTianjin Key Laboratory of Acute Abdomen Disease Associated Organ Injury and ITCWM RepairTianjin Nankai Hospital, Tianjin Medical UniversityTianjin Nankai Hospital, Tianjin Medical UniversityTianjin Key Laboratory of Acute Abdomen Disease Associated Organ Injury and ITCWM RepairAbstract Objective This study aimed to evaluate the value of cancer-associated fibroblasts (CAFs) that positively express α-smooth muscle actin (α-SMA) and fibroblast activation protein (FAP) as survival indicators for patients with extrahepatic cholangiocarcinoma (eCCA). Methods The clinicopathological data of eCCA patients who underwent surgical treatment in Tianjin Nankai Hospital from January 1, 2019, to December 31, 2022, were retrospectively analysed. A total of 79 patients were included, 49 were male and 30 were female, with an age of (64.3 ± 8.3) years. Clinicopathological data such as age, gender, tumour location, lymph node metastasis, tumour differentiation degree, and TNM stage of the patients were recorded. The expressions of α-SMA and FAP, the markers of CAFs, in eCCA were detected by immunohistochemistry. The relationships between the expressions of the two proteins and the clinicopathological data and prognosis of the patients were analysed. Results The positive expressions of α-SMA and FAP in CAFs were observed in 78.5% (62/79) and 35.4% (28/79) of the patients, respectively. There was a highly positive correlation between the expression of α-SMA and that of FAP (r = 0.992, P < 0.001). Univariate analysis showed that CAFs with positive FAP expression and tumour location were statistically significant in terms of overall survival time and recurrence-free survival time. Multivariate analysis indicated that positive FAP expression and tumour location might be independent factors affecting overall survival time and recurrence-free survival time. Conclusions CAFs with positive FAP expression may be a prognostic indicator of poor postoperative survival in eCCA patients and may serve as an independent predictor of poor postoperative survival rate in these patients.https://doi.org/10.1186/s13000-025-01691-6Cancer-associated fibroblastCholangiocarcinomaAlpha smooth muscle actinFibroblast activation proteinPrognosis
spellingShingle Xiaojun Sui
Zhangqiang Zheng
Lei Yang
Dapeng Zhang
Xiangyu Sun
Ximo Wang
Association of α-SMA/FAP-positive cancer-associated fibroblasts with clinicopathological features and prognosis in extrahepatic cholangiocarcinoma
Diagnostic Pathology
Cancer-associated fibroblast
Cholangiocarcinoma
Alpha smooth muscle actin
Fibroblast activation protein
Prognosis
title Association of α-SMA/FAP-positive cancer-associated fibroblasts with clinicopathological features and prognosis in extrahepatic cholangiocarcinoma
title_full Association of α-SMA/FAP-positive cancer-associated fibroblasts with clinicopathological features and prognosis in extrahepatic cholangiocarcinoma
title_fullStr Association of α-SMA/FAP-positive cancer-associated fibroblasts with clinicopathological features and prognosis in extrahepatic cholangiocarcinoma
title_full_unstemmed Association of α-SMA/FAP-positive cancer-associated fibroblasts with clinicopathological features and prognosis in extrahepatic cholangiocarcinoma
title_short Association of α-SMA/FAP-positive cancer-associated fibroblasts with clinicopathological features and prognosis in extrahepatic cholangiocarcinoma
title_sort association of α sma fap positive cancer associated fibroblasts with clinicopathological features and prognosis in extrahepatic cholangiocarcinoma
topic Cancer-associated fibroblast
Cholangiocarcinoma
Alpha smooth muscle actin
Fibroblast activation protein
Prognosis
url https://doi.org/10.1186/s13000-025-01691-6
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