Objective To study the expression of ERK1/2 and p-ERK1/2 in cholangiocarcinoma and its clinical signif-icance. Methods ERK1/2 and p-ERK1/2 protein expression were detected in 74 cases of cholangiocarcinoma and 25 cases of normal bile ducts tissues using immunohistochemistry (SP method). The correlations of expression of ERK1/2 and p-ERK1/2 with the clinical index were detected by chi-square test. Survival probabilities were estimated by the Kaplan-Meier method and assessed by a Log-rank test. The Kapla-Meier model was used to analyze single factor. Cox's proportional hazard regression model was performed to evaluate the multi-factors. Results The positive expres-sion rate of ERK1/2 and p-ERK1/2 in the cholangiocarcinoma tissues were 32.4% (24/74), 60.8% (45/74), which were significantly higher than those in normal bile ducts tissues [16.0% (4/25), 24.0% (6/25)], the differences were statisti-cally significant (P < 0.05). The expression of p-ERK1/2 protein was associated with lymph node metastases state and differentiation level of tumor (P < 0.05). The survival time in patients with p-ERK1/2 negative expression was longer than patients with positive expression (P=0.034). Single factor analysis showed that p-ERK1/2 expression, dif-ferentiated degree of tumor, lymphatic metastasis and clinical stages were connected with prognosis (P < 0.05). Mul-ti-factor analysis proved that p-ERK1/2 expression and clinical stages could be regarded as independent risk factors of cholangiocarcinoma prognosis (P < 0.05). Conclusion There are higher expression of ERK1/2 and p-ERK1/2 in cholangioc arcinoma. p-ERK1/2 and clinical stages may be served as a prognostic factor in cholangiocarci-noma.%目的：检测细胞外信号调节激酶1/2（ERK1/2）和其磷酸化状态（p-ERK1/2）在胆管癌组织中的蛋白表达及临床意义。方法收集肝外胆管癌组织标本74例，正常胆囊结石胆囊管组织标本25例，应用SP免疫组化法检测ERK1/2和p-ERK1/2蛋白的表达情况；采用卡方检验分析ERK1/2和p-ERK1/2表达水平与临床指标关系；应用Kaplan-Meier法绘制生存曲线，单因素分析采用Kaplan-Meier模型，多因素分析采用COX比例风险模型。结果胆管癌组织中ERK1/2和p-ERK1/2蛋白表达阳性率分别为32.4%（24/74）和60.8%（45/74），均明显高于正常肝外胆管组织[16.0%（4/25）、24.0%（6/25）]，差异均有统计学意义（P<0.05）。p-ERK1/2蛋白表达与淋巴结转移和肿瘤分化程度密切相关（P<0.05）；p-ERK1/2阴性表达的肝外胆管癌患者总体生存期明显长于p-ERK1/2表达阳性的患者（P=0.034）。单因素分析发现，p-ERK1/2的表达、淋巴结有无转移、临床分期和肿瘤的分化程度均与患者预后相关（P<0.05），多因素分析证实p-ERK1/2的表达是影响预后的独立风险因素(P<0.05)。结论胆管癌组织存在ERK1/2和p-ERK1/2高表达；p-ERK1/2的表达与临床分期可作为胆管癌的预后因子。
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