Clinicopathological significance of stanniocalcin-2 expression in adenocarcinomas of biliary tract

Background: Despite all efforts, patients with biliary tract cancer (BTC) still share a dismal outcome. Based on its lack of specific symptoms, BTCs are often diagnosed in an advanced stage. Molecular biomarkers augur to overcome this misery, but none has entered clinical routine yet. We sought to investigate the prognostic relevance of Stanniocalcin-2 (STC2), which has shown encouraging results in other tumors, for its potential as biomarker in BTC. Material and methods: We first evaluated STC2 expression and its prognostic properties on mRNA level in silico using the TCGA (The Cancer Genome Atlas) database. In a second step, we validated the results using STC2 immunohistochemistry in a tissue microarray consisting of an independent cohort of BTCs who underwent resection at our center from 2000-2012. Results: TCGA data of 36 cholangiocellular carcinomas (CCC) revealed a significantly higher expression level of STC2 compared to normal tissue (P < 0.001) and a significant correlation to lymphatic infiltration (P = 0.020), but no impact on overall survival. In our cohort consisting of 53 patients with CCC and 11 patients with gallbladder cancer (GBC), STC2 also showed an over expression in CCC and GBC tissue and a correlation to lymphatic metastasis (P = 0.038). Patients with STC2 positive tumors had a significant worse overall survival (P = 0.007) and STC2 was an independent prognostic marker (P = 0.022). Conclusion: Valid biomarkers for BTC are desperately needed. STC2 has proven its potential as a prognostic marker in other tumors and showed promising observation in our study. Nonetheless, these findings have to be validated in a prospective cohort.

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