CAJ | 학술논문

目的研究上皮间质转化和肝细胞癌肺转移的关系.方法 2000年1月至2004年3月于中山医院肝外科手术病理诊断为肝细胞癌的患者中,根据术后随访期内有无肺转移分为有肺转移组和无远处转移组,每组随机选择50例患者的原位肝癌组织制成组织芯片.用免疫组织化学染色(二步法)方法检测组织芯片上肺转移组和无远处转移组患者的肝痛组织的上皮间质转化的标志(E-cadherin、Vimentin、Fibronectin),单因素和多因素分析这些标志和肝细胞癌肺转移的关系.结果单因素分析了性别、年龄、HbsAg、甲胎蛋白(AFP)、肿瘤大小、数目、癌栓、包膜、肝门淋巴结、肿瘤分化程度、E-钙黏蛋白(E-cadherin)、波形蛋白(Vimentin)、纤维连接蛋白(Fibroneetin)的表达与肺转移的相关性,结果显示:患者AFP水平>400 ng/ml、肿瘤直径>10 cm、门静脉癌栓、分化程度低、E-cadherin的低表达、Fibronectin的高表达、Vimentin的高表达与肝细胞癌肺转移相关;多因素分析显示肿瘤直径>10 cm、门静脉癌栓、分化程度低、Fibronectin高表达是肝细胞癌肺转移的危险因素.结论肝细胞癌患者肝癌组织的上皮间质转化与其发生肺转移有密切关系.
목적 연구상피간질전화화간세포암폐전이적관계.방법 2000년1월지2004년3월우중산의원간외과수술병리진단위간세포암적환자중,근거술후수방기내유무폐전이분위유폐전이조화무원처전이조,매조수궤선택50례환자적원위간암조직제성조직심편.용면역조직화학염색(이보법)방법검측조직심편상폐전이조화무원처전이조환자적간통조직적상피간질전화적표지(E-cadherin、Vimentin、Fibronectin),단인소화다인소분석저사표지화간세포암폐전이적관계.결과 단인소분석료성별、년령、HbsAg、갑태단백(AFP)、종류대소、수목、암전、포막、간문림파결、종류분화정도、E-개점단백(E-cadherin)、파형단백(Vimentin)、섬유련접단백(Fibroneetin)적표체여폐전이적상관성,결과현시:환자AFP수평>400 ng/ml、종류직경>10 cm、문정맥암전、분화정도저、E-cadherin적저표체、Fibronectin적고표체、Vimentin적고표체여간세포암폐전이상관;다인소분석현시종류직경>10 cm、문정맥암전、분화정도저、Fibronectin고표체시간세포암폐전이적위험인소.결론 간세포암환자간암조직적상피간질전화여기발생폐전이유밀절관계.
Objective To evaluate the relationship between epithelial mesenchymal transition (EMT) and lung metastasis in hepatocellular carcinoma. Methods There were 100 patients who underwent surgical resection of hepatocellular carcinoma between January 2000 and March 2004. They were classified with non-distance metastasis and lung metastasis depend on the close following up till March 2007. Their hepatocellular carcinoma specimens were retrospectively examined for EMT markers(E-cadherin, Vimentin,Fibronectin) with immunochemistry staining in tissue microarray. Univariate and multivariate analysis were used for study the relationship between EMT and lung metastasis. Results Univariate analysis showed that down regulation of E-cadherin,overexpression of fibronectin, cytosolic expression of vimentin, AFP≥400 ng/ml, tumor size more than 10 cm, portal vein involvement, poorly differentiated of tumor had close correlation with lung metastasis. Multivariate analysis indicated that overexpression of fibronectin was independent factor for lung metastasis apart from tumor size more than 10 cm, portal vein involvement and poorly differentiated of tumor. Conclusion The results proposed that EMT has close relation with lung metastasis in hepatoceilular carcinoma.