CAJ | 학술논문

目的：探讨人源电压门控质子通道蛋白（HVCN1）在肝细胞癌（肝癌）组织中的表达及其对肝癌根治性切除术后患者生存预后的影响。方法回顾性分析2008年8月至2009年12月在广州医科大学附属肿瘤医院行肝癌根治性切除术的92例患者临床资料，并选取其肝癌及癌旁组织进行研究。其中男82例，女10例；平均年龄（51±12）岁。所有患者均签署知情同意书，符合医学伦理学规定。采用免疫组化法检测肝癌及癌旁组织HVCN1表达。观察肝癌组织中HVCN1的表达，分析HVCN1阳性表达与患者临床病理学参数的关系，并对患者的生存预后及其影响因素进行分析。HVCN1的表达及其与临床病理学参数的关系采用χ2检验或Fisher确切概率法。生存分析采用Kaplan-Meier法和Log-rank检验。生存预后影响因素分析采用Cox比例风险回归模型。结果肝癌组织HVCN1阳性表达率为29%（27/92），明显高于癌旁组织的12%（5/40）（χ2=2.076, P<0.05）。肝癌组织中HVCN1高表达与肿瘤包膜（P<0.05）、血管侵犯（χ2=4.937, P<0.05）、术后早期复发有关（χ2=8.081， P<0.05）。HVCN1阳性表达患者的1、3、5年累积生存率分别为81.5%、41.0%、29.3%，HVCN1阴性表达患者为92.1%、61.0%、61.0%，HVCN1阳性表达患者的总体生存率明显低于HVCN1阴性表达患者（χ2=8.226，P<0.05）。HVCN1阳性表达患者的1、3、5年无瘤生存率分别为51.9%、13.5%、13.5%，HVCN1阴性表达患者为70.6%、34.0%、34.0%，HVCN1阳性表达患者的无瘤生存率明显低于HVCN1阴性表达患者（χ2=5.302，P<0.05）。多因素Cox回归分析显示，HVCN1阳性表达、肝硬化是影响肝癌根治性肝切除术后患者生存预后的独立危险因素（RR=2.520,2.408；P<0.05）。结论HVCN1在肝癌组织中高表达，与肿瘤包膜、血管浸润、术后早期复发相关，是影响肝癌根治性切除术后患者生存预后的独立危险因素，可作为肝癌患者根治性切除术后的预测指标。目的：探討人源電壓門控質子通道蛋白（HVCN1）在肝細胞癌（肝癌）組織中的錶達及其對肝癌根治性切除術後患者生存預後的影響。方法迴顧性分析2008年8月至2009年12月在廣州醫科大學附屬腫瘤醫院行肝癌根治性切除術的92例患者臨床資料，併選取其肝癌及癌徬組織進行研究。其中男82例，女10例；平均年齡（51±12）歲。所有患者均籤署知情同意書，符閤醫學倫理學規定。採用免疫組化法檢測肝癌及癌徬組織HVCN1錶達。觀察肝癌組織中HVCN1的錶達，分析HVCN1暘性錶達與患者臨床病理學參數的關繫，併對患者的生存預後及其影響因素進行分析。HVCN1的錶達及其與臨床病理學參數的關繫採用χ2檢驗或Fisher確切概率法。生存分析採用Kaplan-Meier法和Log-rank檢驗。生存預後影響因素分析採用Cox比例風險迴歸模型。結果肝癌組織HVCN1暘性錶達率為29%（27/92），明顯高于癌徬組織的12%（5/40）（χ2=2.076, P<0.05）。肝癌組織中HVCN1高錶達與腫瘤包膜（P<0.05）、血管侵犯（χ2=4.937, P<0.05）、術後早期複髮有關（χ2=8.081， P<0.05）。HVCN1暘性錶達患者的1、3、5年纍積生存率分彆為81.5%、41.0%、29.3%，HVCN1陰性錶達患者為92.1%、61.0%、61.0%，HVCN1暘性錶達患者的總體生存率明顯低于HVCN1陰性錶達患者（χ2=8.226，P<0.05）。HVCN1暘性錶達患者的1、3、5年無瘤生存率分彆為51.9%、13.5%、13.5%，HVCN1陰性錶達患者為70.6%、34.0%、34.0%，HVCN1暘性錶達患者的無瘤生存率明顯低于HVCN1陰性錶達患者（χ2=5.302，P<0.05）。多因素Cox迴歸分析顯示，HVCN1暘性錶達、肝硬化是影響肝癌根治性肝切除術後患者生存預後的獨立危險因素（RR=2.520,2.408；P<0.05）。結論HVCN1在肝癌組織中高錶達，與腫瘤包膜、血管浸潤、術後早期複髮相關，是影響肝癌根治性切除術後患者生存預後的獨立危險因素，可作為肝癌患者根治性切除術後的預測指標。
목적：탐토인원전압문공질자통도단백（HVCN1）재간세포암（간암）조직중적표체급기대간암근치성절제술후환자생존예후적영향。방법회고성분석2008년8월지2009년12월재엄주의과대학부속종류의원행간암근치성절제술적92례환자림상자료，병선취기간암급암방조직진행연구。기중남82례，녀10례；평균년령（51±12）세。소유환자균첨서지정동의서，부합의학윤리학규정。채용면역조화법검측간암급암방조직HVCN1표체。관찰간암조직중HVCN1적표체，분석HVCN1양성표체여환자림상병이학삼수적관계，병대환자적생존예후급기영향인소진행분석。HVCN1적표체급기여림상병이학삼수적관계채용χ2검험혹Fisher학절개솔법。생존분석채용Kaplan-Meier법화Log-rank검험。생존예후영향인소분석채용Cox비례풍험회귀모형。결과간암조직HVCN1양성표체솔위29%（27/92），명현고우암방조직적12%（5/40）（χ2=2.076, P<0.05）。간암조직중HVCN1고표체여종류포막（P<0.05）、혈관침범（χ2=4.937, P<0.05）、술후조기복발유관（χ2=8.081， P<0.05）。HVCN1양성표체환자적1、3、5년루적생존솔분별위81.5%、41.0%、29.3%，HVCN1음성표체환자위92.1%、61.0%、61.0%，HVCN1양성표체환자적총체생존솔명현저우HVCN1음성표체환자（χ2=8.226，P<0.05）。HVCN1양성표체환자적1、3、5년무류생존솔분별위51.9%、13.5%、13.5%，HVCN1음성표체환자위70.6%、34.0%、34.0%，HVCN1양성표체환자적무류생존솔명현저우HVCN1음성표체환자（χ2=5.302，P<0.05）。다인소Cox회귀분석현시，HVCN1양성표체、간경화시영향간암근치성간절제술후환자생존예후적독립위험인소（RR=2.520,2.408；P<0.05）。결론HVCN1재간암조직중고표체，여종류포막、혈관침윤、술후조기복발상관，시영향간암근치성절제술후환자생존예후적독립위험인소，가작위간암환자근치성절제술후적예측지표。
ObjectiveTo investigate the expression of human voltage-gated proton channel 1 (HVCN1) in hepatocellular carcinoma (HCC) and its significance in survival and prognosis after radical hepatectomy.MethodsClinical data of 92 patients with HCC undergoing radical hepatectomy in the Cancer Center of Guangzhou Medical University between August 2008 and December 2009 were retrospectively studied. The HCC ard para-carcinoma tissues were chosen and studied. Among the 92 patients, 82 were males and 10 were females with the average age of (51±12) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. HVCN1 expression in HCC and para-carcinoma tissues was detected by immunohistochemistry. HVCN1 expression in HCC tissues was observed and the correlation between the positive expression of HVCN1 and clinicopathological parameters was analyzed. In addition, the survival and prognosis of HCC patients as well as the influencing factors were also analyzed. The analysis on the correlation between the expression of HVCN1 and clinicopathological parameters was conducted using Chi-square test or Fisher's Exact Test. The survival analysis was conducted using Kaplan-Meier method and Log-rank test. The analysis on influencing factors of survival and prognosis was conducted using Cox Proportional Hazard Regression Model.Results The positive expression of HVCN1 in HCC tissues was 29% (27/92), which was significantly higher than 12% (5/40) of that in para-carcinoma tissues (χ2=2.076,P<0.05). High HVCN1 expression in HCC tissues was correlated with tumor capsule (P<0.05), vascular invasion (χ2=4.937,P<0.05) and early postoperative recurrence (χ2=8.081,P<0.05). The 1-, 3-, 5-year accumulated survival rate was respectively 81.5%, 41.0%, 29.3% for patients with positive HVCN1 expression, and 92.1%, 61.0%, 61.0% for patients with negative HVCN1 expression. The overall survival rate of patients with positive HVCN1 expression was significantly lower than that of patients with negative HVCN1 expression (χ2=8.226,P<0.05). The 1-, 3-, 5-year disease-free survival rate was respectively 51.9%, 13.5%, 13.5% for patients with positive HVCN1 expression and 70.6%, 34.0% and 34.0% for patients with negative HVCN1 expression. The disease-free survival rate of patients with positive HVCN1 expression was significantly lower than that of patients with negative HVCN1 expression (χ2= 5.302,P<0.05). Multivariate Cox regression analysis showed that positive HVCN1 expression and liver cirrhosis were the independent risk factors affecting the survival and prognosis of patients with HCC after radical hepatectomy (RR=2.520,2.408;P<0.05).Conclusions High HVCN1 expression in HCC tissues was correlated with tumor capsule, vascular invasion and early postoperative recurrence, and is the independent risk factor affecting the survival and prognosis of patients with HCC after radical hepatectomy, which can be used as the predictive index for patients with HCC after radical hepatectomy.