Background: By studying the expression of epithelial-mesenchymal transition regulators in cholangiocarcinoma and intrahepatic duct stones, the correlation between the expression of epithelial-mesenchymal transition regulators and cholangiocarcinoma was revealed. Objective: The objective is to investigate the correlation between the expression of epithelial-mesenchymal transition (EC) regulatory factors and cholangiocarcinoma in patients with intrahepatic duct stones and cholangiocarcinoma, to investigate the relationship between clinicopathological features and prognosis, and to observe the expression of molecular markers of epithelial-mesenchymal transition (EMT) in intrahepatic duct stones and bile duct carcinoma. Methods: Twenty cases of primary cholangiocarcinoma, 20 cases of intrahepatic cholangiolithiasis complicated with cholangiocarcinoma, and 20 cases of intrahepatic cholangiolithiasis specimens were collected from the Fourth People’s Hospital and the friendly medical unit of Haikou. Immunohistochemistry was used to detect the expression differences of EMT-related molecular markers Twisit1, Twisit2, E-cadherin, N-cadherin, and Vimentin in paraffin sections of normal intrahepatic bile duct tissues and patients with intrahepatic duct stones and cholangiocarcinoma. Results: Immunohistochemical staining revealed epithelial-mesenchymal transition (EMT) in intrahepatic cholangiocarcinoma tissue, intrahepatic cholangiolithiasis with cholangiocarcinoma, intrahepatic cholangiolithiasis with normal intrahepatic cholangiolithiasis, such as Sit1, Twisit2, E-cadherin, N-cadherin, and Vimentin proteins were different. The expression of E-cadherin was decreased in cholangiocarcinoma tissue and intrahepatic cholangiolithiocarcinoma combined with cholangiocarcinoma (P 0.05). There was no difference in the expression of intrahepatic bile duct stones and EMT (P > 0.05). Conclusion: The expression of E-cadherin, the molecular marker of EMT, was down-regulated, while the expression of N-cadherin and Vimentin was up-regulated. Age, gender, depth of tumor invasion, degree of tumor differentiation and lymph node metastasis were correlated with the expression of EMT in intrahepatic cholangiocarcinoma.
In this study, tumor microenvironment and related pathways play an important role in the EMT process of bile duct tumors to analyze the role of EMT in the occurrence and development of cholangiolithiasis associated bile duct carcinoma and investigate the expression of EMT in intrahepatic cholangiolithiasis associated cholangiocarcinoma and its clinical significance.
In 2006, Duman et al. proposed “Neurotrophic Theory of Depression” [1]. According to the hypothesis, stress leads to a decrease in the expression of neurotrophic factors such as Brain-derived neurotrophic factor (BDNF) in the limbic structure, and antidepressant therapy can partially reverse the effect caused by stress. The reduction of BDNF and other neurotrophic factors promotes the atrophy of certain brain structures, especially the hippocampus and prefrontal cortex, while antidepressant treatment increases the level of BDNF in the brain, and improves synaptic plasticity and neuronal survival in related brain regions. Neurotrophic factors are a class of molecules that act on the nervous system and play an important role in maintaining cell function. They can regulate the growth, survival, differentiation and cell cycle of nerve cells. There is a hypothesis of neuroendocrine dysfunction in the neurobiochemical mechanism of depression, which is mainly the abnormal activity of the hypothalamic-pituitary-adrenal axis (HPA) and hypothalamic-pituitary-thyroid axis (HPT). This article reviews the related research on depression and brain-derived neurotrophic factors in order to guide clinical research and treatment.
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