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Pathol Int. 2018 May;68(5):294-300. doi: 10.1111/pin.12657. Epub 2018 Mar 14.

Clinicopathological and prognostic significance of heme oxygenase-1 expression in small intestinal adenocarcinomas.

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Department of Pathology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Republic of Korea.
Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Department of Pathology, Yeungnam University College of Medicine, Daegu, Republic of Korea.
Department of Pathology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
Department of Pathology, Chonbuk National University Medical School, Jeonju, Republic of Korea.
Department of Pathology, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Republic of Korea.


Heme oxygenase-1 (HO-1), a stress-response protein, is highly induced in various carcinomas. It is implicated in carcinogenesis and tumor progression. High HO-1 expression is associated with better prognosis of patients with colorectal and gastric cancers. Induction or inhibition of HO-1 can mediate chemo-sensitivity, therefore it might be a therapeutic target to develop anticancer agents. To define the clinicopathological and prognostic significance of HO-1 expression in small-intestinal adenocarcinomas (SIACs), immunohistochemical microarray analysis of HO-1 expression was performed for 191 surgically resected SIAC cases and results were compared with various clinicopathologic variables, including survival. HO-1 was highly expressed in 127 (66.5%) cases. Patients with high HO-1 expression were associated with younger age (P = 0.048), lower pT category (P = 0.017), and less pancreatic invasion (P = 0.047). Patients with high HO-1 expression tended to have longer overall survival (median, 38.5 months) than those with low HO-1 expression (24.5 months), although the difference in overall survival was not statistically significant (P = 0.677). In summary, high HO-1 expression is frequently observed in SIACs. It is related to favorable clinicopathologic parameters, including younger age, lower T category, and less pancreatic invasion. Therefore, HO-1 may serve as a prognostic marker and a new target to modulate chemotherapeutic effects in patients with SIACs.


heme oxygenase-1; immunohistochemistry; small intestine; survival

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