CAJ | 학술논문

目的：检测 PEG10在原发性肝癌（PHC）组织中表达的情况，探讨其与临床病理参数的关系及对肝癌预后的临床意义。方法应用免疫组织化学方法（SP 法）检测58例 PHC 患者肝组织中 PEG10的表达情况，并分析 PEG10与PHC 临床病理特征及预后的关系。结果58份 PHC 标本中44份 PEG10阳性，其中“＋”16份、“＋＋”13份和“＋＋＋”15份。平均随访时间为40．5 m，至随访结束时共有23例（39．7％）患者死亡；所有患者中位生存时间为31 m，PEG10表达为“－”、“＋”、“＋＋”、“＋＋＋”的中位生存时间分别为57、34、27和15 m，不同 PEG10表达组间生存率差异有统计学意义（P ＝0．000）；PEG10在女性、晚期病例、术前 AFP＞200 ng ／mL、微血管侵犯、低分化肝癌患者肿瘤组织中表达更高（P ＜0．05），而与患者年龄、肿瘤直径、病因无关（P ＞0．05）；早期复发病例中 PEG10阳性比例明显高于阴性（P ＜0．05），而晚期复发病例组间无明显差异（P ＞0．05）。PEG10预测 PHC 复发的诊断特异度77．5％，敏感度为38．9％，准确率为65．5％，多因素 COX 模型中 AJCC 分期、微血管侵犯、病因和 PEG10表达是影响 PHC 预后的危险因素（P ＜0．05），其中 PEG10阳性的 HR 达6．724。结论 PEG10对 PHC 预后具有很好的评估价值，但是其特异性高而敏感性不高，需要联合其他指标作出综合评价。
목적：검측 PEG10재원발성간암（PHC）조직중표체적정황，탐토기여림상병리삼수적관계급대간암예후적림상의의。방법응용면역조직화학방법（SP 법）검측58례 PHC 환자간조직중 PEG10적표체정황，병분석 PEG10여PHC 림상병리특정급예후적관계。결과58빈 PHC 표본중44빈 PEG10양성，기중“＋”16빈、“＋＋”13빈화“＋＋＋”15빈。평균수방시간위40．5 m，지수방결속시공유23례（39．7％）환자사망；소유환자중위생존시간위31 m，PEG10표체위“－”、“＋”、“＋＋”、“＋＋＋”적중위생존시간분별위57、34、27화15 m，불동 PEG10표체조간생존솔차이유통계학의의（P ＝0．000）；PEG10재녀성、만기병례、술전 AFP＞200 ng ／mL、미혈관침범、저분화간암환자종류조직중표체경고（P ＜0．05），이여환자년령、종류직경、병인무관（P ＞0．05）；조기복발병례중 PEG10양성비례명현고우음성（P ＜0．05），이만기복발병례조간무명현차이（P ＞0．05）。PEG10예측 PHC 복발적진단특이도77．5％，민감도위38．9％，준학솔위65．5％，다인소 COX 모형중 AJCC 분기、미혈관침범、병인화 PEG10표체시영향 PHC 예후적위험인소（P ＜0．05），기중 PEG10양성적 HR 체6．724。결론 PEG10대 PHC 예후구유흔호적평고개치，단시기특이성고이민감성불고，수요연합기타지표작출종합평개。
Objective To detect the expression of PEG10 in primary hepatic carcinoma (PHC)tissues,to explore its relationship between clinical pathological parameters and prognosis of PHC.Methods The expression of PEG10 was detected by immunohistochemical (SP method)in 58 carcinoma tissues of PHC patients in our hospital.The relationship between PEG10 and clinical pathological characteristics or prognosis of PHC was analyzed.Results Among 58 specimens, 44 were tested positive for PEG10,including 16 of"+",13 of"++"and 15 of"+++".The average follow-up was 40.5 months,and 23 cases (39.7%)dead by the end of follow-up .The median survival time was 31 months for all cases.And 57 months,34months,27months,15months for PEG10 "-","+","+ +","+ + +"groups,respectively.The survival rate in different groups had significant differences (P = 0.000 ).Levels of PEG10 in the female,advanced tumor, preoperative alpha fetal protein (AFP)>200ng/mL,microvascular invasion and poorly differentiated tumors cases were higher (P <0.05),while had no relation with age,tumor diameter or etiology (P >0.05).Among early recurrent cases, ratio of PEG10-positive was higher than that of PEG10-negative (P < 0.05 ),however,which showed no significant difference in late recurrent groups (P >0.05).The specificity,sensitivity and accuracy rate of PEG10 in prediction of PHC recurrence was 77.5%,38.9% and 65.5%,respectively.AJCC stage,microvascular invasion,etiology and PEG10 expression were risk factors for PHC recurrence by multivariate COX analysis (P <0.05 ),in which PEG10 positive HR was 6.724.Conclusion PEG10 can effectively predict the prognosis of PHC with a high specificity but low sensitivity, which should be conjunct with other indicators to make a comprehensive evaluation.