摘要
目的 探讨乙酰肝素酶 (HPA)和nm2 3 H1在原发性肝细胞肝癌 (HCC)中的相互关系 ,及其作为HCC术后转移复发预测指标的价值。方法 选用 33例HCC癌组织和癌旁组织标本 ,9例肝脏良性肿瘤瘤周肝组织作正常对照。用逆转录聚合酶链反应 (RT PCR)和免疫组化S P法检测标本中HPAmRNA和nm2 3 H1蛋白的表达 ,并结合患者的临床病理指标和随访结果进行分析。结果 33例HCC中 ,16例HPA表达阳性 ,其阳性率显著高于癌旁组织和正常肝组织 (P <0 0 1)。HPA表达与肿块大小、包膜形成、AFP水平、HBsAg状态和有无肝硬化等无关 (P >0 0 5 ) ;但高转移复发倾向组和随访转移复发组HPA表达率显著高于低转移复发倾向组 (P <0 0 5 )和无转移复发组 (P <0 0 1) ;此外 ,HPA基因表达多见于分化较差 (P <0 0 5 )、TNM分期较晚 (P <0 0 5 )的患者。nm2 3 Hl蛋白在HCC癌组织中的阳性率显著低于癌旁和正常肝组织 (P <0 0 5 )。nm2 3 H1与肿块大小、包膜形成、AFP水平、HBsAg状态、有无肝硬化、Edmondson分级和TNM分期均无关 (P >0 0 5 ) ;但高转移复发倾向组和随访转移复发组HPA表达率明显高于低转移复发倾向组 (P =0 0 18)和无转移复发组 (P =0 0 2 4 )。nm2 3 H1在HPA阳性组和阴性组表达差异无显著意义 (P =0 0 82 )。
Objective To explore the relation between heparanase (HPA) and nm23 H1 in hepatocellular carcinoma (HCC), and judge whether they may be used as valuable markers in predicting postoperative metastasis and recurrence of HCC. Methods Reverse transcription polymerase chain reaction (RT PCR) and immunohistochemistry (S P method)were used to measure the expressions of the HPA mRNA and nm23 H1 protein in the primary tumor tissue and paracancer tissue of 33 cases of HCC. The paracancer tissues of 9 cases of benign liver tumor were used as normal controls. The results were analyzed in combination with the results of clinicopathological examination and follow up. Results The expression of HPA gene was positive in 16 cases of primary tumor tissues of HCC with a positive rate of 48.5%, significantly higher than those in paracancer tissues of HCC cases and in normal controls ( P <0.01). The HPA expression was not related with the size of tumor, envelope formation, AFP level, HBsAg state and cirrhosis of liver. The positive rates of HPA mRNA in the group with high tendency to metastasis or recurrence and the group with metastasis or recurrence during follow up were significantly higher than that in the group with low tendency to metastasis or recurrence group ( P <0.05)and that in the group without metastasis or recurrence ( P <0.01).The poorly differentiated tumor and tumor of TNM stage Ⅲ Ⅳ had higher positive rates of HPA gene expression than the well mediate differentiated tumor and tumor of TNM stageⅠ Ⅱ( P <0.05). The positive expression rates of nm23 Hl protein in HCC tissue was significantly lower than that in corresponding non cancerous or normal liver tissue( P <0.05). nm23 Hl expression was not related with the size of tumor, envelope formation, AFP level, HBsAg state, cirrhosis of liver, Edmondson grade, and TNM stage ( P > 0.05). The positive rate of nm23 Hl in the group with high tendency to metastasis and recurrence and in patients with metastasis or recurrence during follow up was obviously higher than that in the group with low tendency to metastasis and recurrence ( P =0.018)and that in the patients without metastasis and recurrence( P =0.024),but no significant difference was found between HPA positive and negative groups( P =0 082). According to the results of follow up, the rates of accuracy in predicting metastasis of positive HPA, negative nm23 H1 and combination of positive HPA with negative nm23 H1 were 78.6%(11/14), 68.8%(11/16) and 88.9%(8/9) respectively. Conclusion Expression of HPA and/or nm23 Hl are related with metastasis and recurrence of HCC. Combining the expression rate of HPA with the expression rate of nm23 H1 may increase the accuracy in predicting HCC postoperative metastasis and recurrence.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2002年第22期1553-1556,共4页
National Medical Journal of China
