CAJ | 학술논문

目的：探讨不同形态亚型的结节型肝细胞癌病理组织中 VEGF、微血管密度表达及患者预后生存情况。方法收集2008年3月至2010年11月行手术切除的癌症组织标本103份，研究对象根据肝癌大体形态分为3组：单个结节型肝细胞癌组（SN 组），多结节融合型细胞癌组（CM 组）和单个结节外生长细胞癌组。SP 免疫组化法分析癌症组织VEGF 阳性表达情况；免疫组化分析微血管密度（MVD）；Western 印迹检测组织中 p-Akt 表达情况；采用 Kaplan-Meier 生存分析3种亚型患者近4年的生存情况。结果 CM 组、SNEG 组患者 VEGF 阳性表达率（CM 组为78．95％，SNEG 组为92．00％）以及 MVD 表达（CM 为11．77±1．37，SNEG 组为19．83±2．06）高于 SN 组（VEGF 阳性表达率为67．80％，MVD表达量为6．75±1．21），其中 SNEG 组同 SN 组相比，差异具有统计学意义（P ＜0．05）；Western 印迹检测结果显示 SNEG组 p-Akt 相对表达量（0．891±0．059），CM 组为（0．681±0．057）均高于 SN 组（0．421±0．039），差异有统计学意义（P ＜0．05或 P ＜0．01），SNEG 组高于 CM 组，具有统计学差异（P ＜0．05）；Kaplan Meier 法进行生存分析 NHC 中 SN 组患者平均生存时间为（3．4±0．3）年，明显高于 CM 组（2．1±0．5）年和 SNEG 组（0．9±0．3）年（P ＜0．05），SN 组预后优于 CM 组、SNEG 组（P ＜0．05）。结论单个结节外生长细胞癌患者组织中 VEGF、MVD 以及 p-Akt 表达量高于单个结节型肝细胞癌或多结节融合型细胞癌患者组织，可能新生血管的形成与不同亚型结节型肝细胞癌患者生存率有一定的关系。
목적：탐토불동형태아형적결절형간세포암병리조직중 VEGF、미혈관밀도표체급환자예후생존정황。방법수집2008년3월지2010년11월행수술절제적암증조직표본103빈，연구대상근거간암대체형태분위3조：단개결절형간세포암조（SN 조），다결절융합형세포암조（CM 조）화단개결절외생장세포암조。SP 면역조화법분석암증조직VEGF 양성표체정황；면역조화분석미혈관밀도（MVD）；Western 인적검측조직중 p-Akt 표체정황；채용 Kaplan-Meier 생존분석3충아형환자근4년적생존정황。결과 CM 조、SNEG 조환자 VEGF 양성표체솔（CM 조위78．95％，SNEG 조위92．00％）이급 MVD 표체（CM 위11．77±1．37，SNEG 조위19．83±2．06）고우 SN 조（VEGF 양성표체솔위67．80％，MVD표체량위6．75±1．21），기중 SNEG 조동 SN 조상비，차이구유통계학의의（P ＜0．05）；Western 인적검측결과현시 SNEG조 p-Akt 상대표체량（0．891±0．059），CM 조위（0．681±0．057）균고우 SN 조（0．421±0．039），차이유통계학의의（P ＜0．05혹 P ＜0．01），SNEG 조고우 CM 조，구유통계학차이（P ＜0．05）；Kaplan Meier 법진행생존분석 NHC 중 SN 조환자평균생존시간위（3．4±0．3）년，명현고우 CM 조（2．1±0．5）년화 SNEG 조（0．9±0．3）년（P ＜0．05），SN 조예후우우 CM 조、SNEG 조（P ＜0．05）。결론단개결절외생장세포암환자조직중 VEGF、MVD 이급 p-Akt 표체량고우단개결절형간세포암혹다결절융합형세포암환자조직，가능신생혈관적형성여불동아형결절형간세포암환자생존솔유일정적관계。
Objective To investigate vascular endothelial growth factor (VEGF)and microvessel density (MVD)in pathological tissues of different forms of nodular hepatocelluar carcinoma (NHC)subtypes,and to study their relationship with prognosis of the NHC patients.Methods A total of 103 patients,with NHC,which underwent surgical resection at the department of oncology and hepatobiliary surgery in our hospital from March 2008 to November 2010,were enrolled. According to the general form of liver cancer,study subjects were divided into three groups,including single nodular HCC group (SN group),multinodular converged cell carcinoma group (CM group)and single extranodule growth cell carcinoma group (SNEG group).Detections of VEGF and MVD in cancer tissue were carried out by SP immunohistochemical and immunohistochemical methods,respectively.Western blot was conducted to measure the expression of p-Akt in tissues. Survival for nearly four years of patients in three subtypes was analyzed by Kaplan-Meier survival analysis,respectively. Results Compared to SN group,there were more VEGF positive patients with higher levels of MVD expression in CM and SNEG group,and there was a statistically significant difference (P <0.05 )among SNEG and SN groups.Western blot showed that p-Akt expression from liver tissues in SNEG and CM groups was significantly higher than that in SN group (P<0.05 or P <0.01 ),and p-Akt expression in SNEG group was significantly higher than that in CM group (P <0.05 ). Kaplan Meier survival analysis of NHC patients showed that average survival time for patients in SN group was 3.4±0.3 years, which was significantly higher than those in CM (2.1±0.5 years)and SNEG (0.9±0.3 years)(P <0.05)groups.In addition, the prognosis in SN group was better than those in CM and SNEG groups (P <0.05).Conclusion Levels of VEGF,MVD and p-Akt expression in SNEG group were higher than those in SN and CM groups,which showed that there might be a certain relationship between the newborn blood vessel formation and the survival rate of patients with NHC in different subtypes.