Iranian Journal of Pathology

Diagnostic Value of Biomarkers in the Diagnosis of Cholangiocarcinoma and Its Benign Mimickers

Document Type : Original Research

Authors

Elmira Zolfeghari Khiavy 1
Nasser Rakhshani 2
Hamid Rezvani 3
Behnaz Bouzari 1
Hossein Ajdarkosh 2
Mahshid Panahi 1
Hemin Ashayeri 4
Seyed Mir Yaghub Musaviani 1
Soheil Khalili 1
Ali Basi 5
Mohammad Hadi Karbalaie Niya 2, 6

1 Department of Pathology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

2 Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran

3 Department of Adult Hematology Oncology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Islamic Azad University, Tehran Branch, Tehran, Iran

5 Department of Hematology Oncology, Iran University of Medical Sciences, Tehran, Iran

6 Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

https://doi.org/10.30699/ijp.2025.2029980.3307
Abstract
Background & Objective: Cholangiocarcinoma (CCA) is a malignancy that accounts for approximately 3% gastrointestinal cancer. The aim of this study was to evaluate and compare the diagnostic value of CD56, SMAD4, CEA, and p53 biomarkers in diagnosing cholangiocarcinoma and its benign mimickers.
Methods: This retrospective cross-sectional study was conducted on 54 CCA specimens and 27 non-cancerous pancreatobiliary tissue samples diagnosed between 2018 and 2022. All specimens were evaluated using immunohistochemistry (IHC) staining for CD56, SMAD4, CEA, and p53 expression. The cut-off value of each marker was obtained from the respective kit instructions and previous studies. The results were analyzed using SPSS version 26. A significance level of less than 0.05 was considered statistically significant.
Results: Of the 81 specimens, the mean age in the case and control groups was 57.33 ± 11.99 and 44.7 ± 16.69 years, respectively, and 51 (63%) samples were obtained from male patients. We found that 39.5% had grade III p53 expression, 13.5% had grade II p53 expression, 41.9% had grade III CEA expression, and 9.8% had grade II CEA expression. Additionally, 17.3% were positive for CD56 expression, and 7.4% showed SMAD4 loss. There were significant associations between the expression of CEA (79.6%) and p53 (74%) in the CCA group (p-value < 0.05). However, SMAD4 loss and CD56 expression were not statistically significant.
Conclusion: Expression of CEA and p53 based on IHC staining is associated with the occurrence of CCA. However, SMAD4 and CD56 were not significantly associated with CCA. Further survival analysis and sensitivity and specificity assessments are needed to obtain more comprehensive results.

Keywords

Biomarker
Cholangiocarcinoma
Immunohistochemistry

Subjects

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Iranian Journal of Pathology
Volume 20, Issue 2
Spring 2025
Pages 159-166

  • Receive Date 24 September 2024
  • Revise Date 23 March 2024
  • Accept Date 06 December 2024

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