CAJ | 학술논문

目的分析结节型肝细胞性肝癌(hepatocellular carcinoma,HCC)各形态亚型的生存情况,初步探讨 E-钙黏蛋白(E-cadherin)和上皮细胞黏附分子(EpCAM)在结节型 HCC 各亚型中的表达及其相关性.方法选取2008年至2011年在我院手术切除、直径小于5 cm 且经病理证实为结节型 HCC 的肿瘤组织,根据其大体形态划分为3个亚组:单个结节组(SN 组)61例;单个结节伴有结外生长组(SNEG 组)21例;多结节融合型组(CM 组)18例.应用免疫组织化学 SP 法检测E-cadherin 蛋白和 EpCAM 蛋白在结节型 HCC 各亚型中的表达情况,并初步探讨两者的相关性.采用 Kaplan-Meier 生存统计分析结节型 HCC 3种亚型的生存情况.结果结节型 HCC 中 SN 组的平均生存时间为(33.5±0.9)月,明显高于SNEG 组(24.3±2.6)月和 CM 组(29.3±2.6)月,SN 组与 SNEG 组比较,差异有统计学意义(P<0.01).E-cadherin 在 SN 组、SNEG 组、CM 组中的阳性表达率分别为40.98%(25/61)、9.52%(2/21)、27.78%(5/18)(P<0.05),其中 SN 组与 SNEG组比较,差异有统计学意义(P<0.05).EpCAM 在 SN 组、SNEG 组、CM 组中的阳性表达率分别为22.95%(14/61)、52.38%(11/21)、27.78%(5/18)(P<0.05),其中 SN 组与 SNEG 组比较,差异有统计学意义(P<0.05).相关性分析结果显示 E-cadherin与 EpCAM 两者的阳性表达呈负相关(r=-0.580,P<0.01).结论结节型 HCC 中的 SNEG 有潜在的复发风险;E-cadherin 低表达与 EpCAM 高表达提示 HCC 患者术后预后不良,可作为评估预后的联合诊断指标.
목적분석결절형간세포성간암(hepatocellular carcinoma,HCC)각형태아형적생존정황,초보탐토 E-개점단백(E-cadherin)화상피세포점부분자(EpCAM)재결절형 HCC 각아형중적표체급기상관성.방법선취2008년지2011년재아원수술절제、직경소우5 cm 차경병리증실위결절형 HCC 적종류조직,근거기대체형태화분위3개아조:단개결절조(SN 조)61례;단개결절반유결외생장조(SNEG 조)21례;다결절융합형조(CM 조)18례.응용면역조직화학 SP 법검측E-cadherin 단백화 EpCAM 단백재결절형 HCC 각아형중적표체정황,병초보탐토량자적상관성.채용 Kaplan-Meier 생존통계분석결절형 HCC 3충아형적생존정황.결과결절형 HCC 중 SN 조적평균생존시간위(33.5±0.9)월,명현고우SNEG 조(24.3±2.6)월화 CM 조(29.3±2.6)월,SN 조여 SNEG 조비교,차이유통계학의의(P<0.01).E-cadherin 재 SN 조、SNEG 조、CM 조중적양성표체솔분별위40.98%(25/61)、9.52%(2/21)、27.78%(5/18)(P<0.05),기중 SN 조여 SNEG조비교,차이유통계학의의(P<0.05).EpCAM 재 SN 조、SNEG 조、CM 조중적양성표체솔분별위22.95%(14/61)、52.38%(11/21)、27.78%(5/18)(P<0.05),기중 SN 조여 SNEG 조비교,차이유통계학의의(P<0.05).상관성분석결과현시 E-cadherin여 EpCAM 량자적양성표체정부상관(r=-0.580,P<0.01).결론결절형 HCC 중적 SNEG 유잠재적복발풍험;E-cadherin 저표체여 EpCAM 고표체제시 HCC 환자술후예후불량,가작위평고예후적연합진단지표.
@@@@Objective To correlate expression of E-cadherin and EpCAM with the survival prognosis of patients with nodular hepato-cellular carcinoma(HCC). Methods A total of 100 patients with HCC who underwent surgery at the Affiliated Tumor Hospital of Guangxi Medical University between 2008 and 2011 were selected for this study.These patients had been diagnosed with HCC on the basis of pathology,and they had primary tumors less than 5 cm in diameter.Patients were divided into 3 groups:single nodule(SN) group(n=61),single nodular with extranodular growth(SNEG)group(n=21),and a confluent multinodular(CM)group(n=18).Expres-sion of E-cadherin and EpCAM was assessed in each group by immunohistochemistry,and Kaplan-Meier survival analysis was per-formed. Results Mean postoperative survival was 33.51±0.89 months in the SN group,which was significantly higher than the 24.25±2.58 months in the SNEG group(P=0.000)and higher(but not significantly)than the 29.30±2.59 months in the CM group.The rate of expression of E-cadherin was 40.98%(25/61)in the SN group,9.52%(2/21)in the SNEG group,and 27.78%(5/18)in the CM group (P<0.05).The corresponding results for EpCAM were 22.95%(14/61),52.38%(11/21),and 27.78%(5/18)(P<0.05).The rates of E-cadherin and EpCAM expression differed significantly between the SN and SNEG groups(P<0.05 in both cases).Pearson correlation analysis showed a negative correlation in the levels of these two proteins(r=-0.580,P<0.05). Conclusions Patients in the SNEG group may be at risk of HCC recurrence.Low expression of E-cadherin and high expression of EpCAM are associated with poor prognosis in patients with HCC.The negative correlation be tween E-cadherin and EpCAM expression suggests that these two proteins may be used together to predict prognosis of patients with HCC.