CAJ | 학술논문

目的探讨出血性铁过载对肝癌组织中Kupffer细胞(KC)分布的影响及其意义.方法分析143例肝癌手术患者癌灶体积大小、是否合并出血、计算出血率；采用随机对照试验收集15例肝癌合并癌灶出血患者(出血组),10例未合并癌灶出血患者的资料(非出血组).采用普鲁士蓝反应(铁染色)检测出血组与非出血组患者的肝癌组织中铁分布；采用免疫组织化学链霉素抗生物素蛋白-过氧化酶连接法(SP法)等技术检测癌组织中转铁蛋白受体(TfR)及KC表面CD68表达,图像分析仪确定其表达量.结果 143例肝癌患者合并出血的36例,出血率为25％,瘤体平均直径大于6 cm；出血组肝癌组织中铁染色阳性吸光度值明显高于非出血组(0.87±0.21比0.43±0.15,P＜0.01),而且TfR表达也明显高于非出血组(0.31 ±0.08比0.14 ±0.05,P＜0.01),导致出血性铁过载；而出血组肝癌中KC的CD68表达减少,明显低于非出血组(0.18 ±0.03比0.32±0.06,P＜0.05)；出血组肝癌组织中铁过载与KC分布减少呈正相关(r=0.815,P＜0.01).结论肝癌出血性铁过载形成高铁胁迫微环境,伴有KC分布减少,从而影响KC的抗肝癌作用.
목적 탐토출혈성철과재대간암조직중Kupffer세포(KC)분포적영향급기의의.방법 분석143례간암수술환자암조체적대소、시부합병출혈、계산출혈솔；채용수궤대조시험수집15례간암합병암조출혈환자(출혈조),10례미합병암조출혈환자적자료(비출혈조).채용보로사람반응(철염색)검측출혈조여비출혈조환자적간암조직중철분포；채용면역조직화학련매소항생물소단백-과양화매련접법(SP법)등기술검측암조직중전철단백수체(TfR)급KC표면CD68표체,도상분석의학정기표체량.결과 143례간암환자합병출혈적36례,출혈솔위25％,류체평균직경대우6 cm；출혈조간암조직중철염색양성흡광도치명현고우비출혈조(0.87±0.21비0.43±0.15,P＜0.01),이차TfR표체야명현고우비출혈조(0.31 ±0.08비0.14 ±0.05,P＜0.01),도치출혈성철과재；이출혈조간암중KC적CD68표체감소,명현저우비출혈조(0.18 ±0.03비0.32±0.06,P＜0.05)；출혈조간암조직중철과재여KC분포감소정정상관(r=0.815,P＜0.01).결론 간암출혈성철과재형성고철협박미배경,반유KC분포감소,종이영향KC적항간암작용.
Objective To investigate the significance of Kupffer cells (KC) distribution changes caused by iron overload in hepatocellular carcinoma (HCC) with haemorrhage.Methods From June 2005 to June 2010,143 cases of HCC operated in the first affiliated hospital of Nanchang University were analyzed retrospectively according to lesion diameter,with or without haemorrhage.We randomly collected 15 specimens from HCC with haemorrbage (bleeding group) and 10 specimens without haemorrhage (nonbleeding group).Prussian blue reaction (iron staining) was used to detect the distribution of iron in the tissues of HCC.Immunohistochemistry (streptavidin-biotin peroxidase method) was used to detect the expression of transferrin receptor (TfR) in the tissues of HCC and the expression of CD68 in KC.The expression amount was determined by usign image analyzer.Results Thirty-six of 143 cases (25％) were complicated with hemorrhage,with average diameter greater than 6 cm.The iron staining positive rate and the expression of TfR in the tissues of bleeding group were significantly higher (0.87 ±0.21 and 0.31 ±0.08 respectively) than in non-bleeding group (0.43 ±0.15 and 0.14 ±0.05 respectively) (for each P ＜0.01),causing hemorrhagic iron overload.On the contrary,the expression of CD68 in KC of bleeding group (0.18 ± 0.03) was obviously lower than that in non-bleeding group (0.32 ± 0.06) (P ＜ 0.05).There was a marked correlation between iron staining and the distribution reduction of KC in bleeding group (r =0.815,P ＜ 0.01).Conclusion HCC with bleeding causes hemorrhagic iron overload and excessive ferrousion stress,accompanying the distribution reduction of KC.It indicates that the anticancer effect of KC in HCC may be influenced.