CAJ | 학술논문

目的探讨半乳糖凝集素(Galectin)-4蛋白在巨大肝癌中的表达及与术后早期复发转移的关系,并建立蛋白数学预测模型.方法采用构建组织芯片结合免疫组织化学方法检测Galectin-4蛋白在73例巨大肝癌术后1年内复发转移与73例未复发转移的癌组织及配对的癌旁组织和10例正常肝组织中的表达,结合临床病理因素进行多因素分析及建立数学预测模型.结果 Galectin-4在巨大肝癌组织中阳性表达率为39.0％(57/146),明显低于癌旁组织的71.9％(105/146,P＜0.05)和正常肝组织的80.0％(8/10,P＜0.05);Galectin-4在12个月内复发转移组阳性表达率为19.1％ (14/73),明显低于未复发转移组的58.9％ (43/73,P＜0.05);Kaplan-Meier生存曲线分析显示Galectin-4阴性表达组1年无瘤生存率(53.1％)明显低于阳性表达组(83.6％,P＜0.05).多因素分析显示,性别、Galectin-4表达、分化程度及镜下脉管癌栓是术后12个月发生复发转移的独立危险因素;由此建立的数学预测模型P=1/[1 +Exp(2.963+性别的B值+分化程度的B值+镜下脉管癌栓的B值+ Galectin-4蛋白表达的B值)],其灵敏度为65.75％,特异度为83.56％,准确度为74.66％.结论 Galectin-4蛋白低表达与巨大肝癌术后早期复发转移有关,建立的数学预测模型具有较高的准确率,可为巨大肝癌术后个体化预测提供依据.
목적 탐토반유당응집소(Galectin)-4단백재거대간암중적표체급여술후조기복발전이적관계,병건립단백수학예측모형.방법 채용구건조직심편결합면역조직화학방법검측Galectin-4단백재73례거대간암술후1년내복발전이여73례미복발전이적암조직급배대적암방조직화10례정상간조직중적표체,결합림상병리인소진행다인소분석급건립수학예측모형.결과 Galectin-4재거대간암조직중양성표체솔위39.0％(57/146),명현저우암방조직적71.9％(105/146,P＜0.05)화정상간조직적80.0％(8/10,P＜0.05);Galectin-4재12개월내복발전이조양성표체솔위19.1％ (14/73),명현저우미복발전이조적58.9％ (43/73,P＜0.05);Kaplan-Meier생존곡선분석현시Galectin-4음성표체조1년무류생존솔(53.1％)명현저우양성표체조(83.6％,P＜0.05).다인소분석현시,성별、Galectin-4표체、분화정도급경하맥관암전시술후12개월발생복발전이적독립위험인소;유차건립적수학예측모형P=1/[1 +Exp(2.963+성별적B치+분화정도적B치+경하맥관암전적B치+ Galectin-4단백표체적B치)],기령민도위65.75％,특이도위83.56％,준학도위74.66％.결론 Galectin-4단백저표체여거대간암술후조기복발전이유관,건립적수학예측모형구유교고적준학솔,가위거대간암술후개체화예측제공의거.
Objective To investigate the expression of galectin-4 protein in huge hepatocellular carcinoma (HCC) and its correlation with recurrence and/or metastasis after surgery,and to establish the mathematical prediction model.Methods The techniques of tissue microarray and immunohistochemical staining were employed to examine the expression profiles of galectin-4 in specimens (both carcinoma tissues and peri-carcinoma tissues) collected from the 73 patients with recurrence/metastasis (≤ 12 months) of HCC,and 73 patients with non-recurrent/metastasis HCC,and those in 10 healthy liver tissues.In addition,the implications of galectin-4 and its correlations with other clinicopathological parameters and recurrence/metastasis were also studied.Results The positive rate of galectin-4 in the carcinoma tissues was 39.0％ (57/146),significantly lower than that in the peri-carcinoma tissues (71.9％,105/146,P ＜0.05) and the healthy liver tissues (80.0％,8/10,P ＜0.05).Galectin-4 protein was expressed in 19.1％ (14/73) of the carcinoma tissues in the recurrence (≤ 12 months) group,and in 58.9％ (43/73) in the non-recurrence group (P＜ 0.05).Kaplan-Meier survival curve analysis showed that the 1-year disease free survival rate in the negative expression of galectin-4 (53.1％) was significantly lower than that in the positive group (83.6％,p ＜ 0.05).Multivariate analysis showed that gender,galectin expression,differentiation and microscopic vascular invasion was independent risk factors for postoperative recurrence (12 months).A mathematical prediction model was established:P =1/[1 + Exp (2.963 + sex of B value + differentiation of B value + B value of microscopic vascular invasion + Galectin-4 protein expression in B value)].The sensitivity,specificity and accuracy for prediction of HCC recurrence (12 months) was 65.75％,83.56％,and 74.66％ respectively.Conclusion Galectin-4 expression may be associated with early recurrence and/or metastasis after surgery in huge HCC.The mathematical prediction model obtained in this study has a high accuracy,which provides the basis for the postoperative individual predictions of huge HCC.