Fascin overexpression correlates with positive thrombospondin-1 and syndecan-1 expressions and a more aggressive clinical course in patients with gallbladder cancer.

This study was conducted to evaluate the prognostic role of fascin expression in gallbladder (GB) cancer and to define the relationship of thrombospondin-1 (TSP-1) and syndecan-1 in fascin expression. We performed immunohistochemical detection of fascin, TSP-1, and syndecan-1 in 43 tissue samples from GB cancer patients who underwent macroscopic complete resection. There were 19 (44%) and 24 (56%) cases having low- and high-grade fascin expression, respectively. The tumors with high-grade fascin expression tended to more frequently show poorer differentiation, deeper invasion depth, lymph node metastasis, a higher American Joint Committee on Cancer stage, and recurrence (each P < 0.05). The patients with high-grade fascin expression had significantly shorter survival periods than those with low-grade fascin expression (P < 0.05). The frequency of positive TSP-1 or syndecan-1 expression in the cases with high-grade fascin expression was significantly higher than that in the cases with low-grade fascin expression (each P < 0.05). These results suggest that a subset of advanced GB cancers revealed a marked overexpression of fascin, which was associated with aggressive clinicopathologic findings and poor overall survival. Furthermore, fascin, TSP-1, and syndecan-1 may act in concert to mediate a more aggressive clinical course through enhanced tumor cell motility.