The antigen determinants masked by formalin-fixation and paraffin-embedding were exposed by heating the section in a microwave oven for 10 min in an em epitope retrieval solution /em (10 mM Tris Base, 1 mM EDTA solution, 0.05% (v/v) Tween 20, pH 9.0). hazard-proportional regression. Results The expression of HSP27 SSI-2 was related to mitotic index, tumor best dimensions, capsular and vascular invasion while the expression of HSP72 was only related to the presence of necrosis and the lymphoid infiltration. Kaplan-Maier analysis suggested that this expression of HSP27 significantly worsened the patients’ median FAA1 agonist-1 overall survival (11 3.18 vs 55 4.1 months, P-value = 0.0003). Moreover HSP27-positive patients exhibited the worst mean survival (7.0 3.2 months) in the absence of concomitant HSP72 expression. Conclusion The expression of HSP27, likely increasing cell proliferation, tumor mass, vascular and capsular invasion, might promote aggressive tumor behaviour in IHCCA and decrease patients’ survival. Immunohistochemical detection of HSP27 on routine sections may provide a reliable prognostic marker for IHCCA able to influence the therapeutic strategies for this malignancy. Background Cholangiocarcinoma is usually a malignant epithelial tumor derived from the bile duct epithelium and the second most common main hepatobiliary malignancy, after hepatocellular carcinoma[1]. Cholangiocarcinoma remains a relatively rare disease, accounting for 2% of all human malignancies [2]. Despite aggressive screening, most patients thought to have localized disease at diagnosis present with advanced stage tumor not amenable to surgical treatment. Chemotherapy and radiotherapy are ineffective in patients with inoperable tumors, and biliary drainage is the mainstay of palliation[3]. The median survival time for patients with intrahepatic cholangiocarcinoma without hilar involvement varies from 18C30 months. HSPs are one of the most evolutionarily conserved classes of molecules and play a fundamental role in the maintenance of cellular homeostasis. Under physiological conditions, they act as molecular chaperones, by assisting protein folding, oligomerization and translocation[4]. During stress they are overexpressed, preventing aggregation and promoting refolding of damaged proteins. Apoptosis resistance is FAA1 agonist-1 often associated with high expression of heat-shock proteins [5-7] (HSPs), and various HSPs inhibitors can induce apoptosis in many tumor models [8]. These mechanisms underscore the role of HSPs in tumor progression and resistance to treatment [9]. The mechanism of HSPs overexpression in malignancy is still a matter of argument [10]. The physiopathological features of the tumor microenvironment such as low glucose, low pH and low oxygen are likely to be involved. In spite of these observations, attempts to correlate the levels of HSPs in tumor samples with clinical prognosis and progression in man have provided controversial results. We focused our attention on intrahepatic cholangiocarcinoma (IHCCA), prompted by epidemiological data, showing a marked increase incidence in our province as well as in the most Western countries[11], and the absence of previous investigations. Aim of the study was the assessment of tissue expression of HSP72 and HSP27 in IHCCA resected with curative intention and the correlation with patients survival. Methods Patients Epidemiological data, from your Parma Tumor Registry (Divisione di Oncologia Medica, Azienda Ospedaliera di Parma), indicated a marked increase in the incidence of IHCCA in our province from 1C2 cases/12 months to 9C12 cases/12 months over the period 1994C2004. Base of the study was a group of 31 patients with IHCCA who underwent resection with radical intention (R0) at the Dipartimento di FAA1 agonist-1 Scienze FAA1 agonist-1 Chirurgiche, Sezione di Clinica Chirurgica Generale e dei Trapianti d’Organo, over the period 1998C2006. Background information including clinical-pathologic data and patients’ survival was retrieved from histological and clinical records. None of the patients experienced received chemotherapy or radiotherapy prior to medical procedures. The study protocol was in accordance with the recommendation of the Declaration of Helsinki. and the indications of Italian DLgs no. 196/03 (Codex on Privacy). Written consent to use stored tissue was obtained from all living patients. Sample sources All pathological samples were retrieved from FAA1 agonist-1 your archives of the Dipartimento di Patologia e Medicina di Laboratorio C.