CAJ | 학술논문

目的：探讨细胞角蛋白19（CK19）在原发性肝透明细胞癌（PCCCL）中的表达及其与患者预后的关系。方法收集2006年11月～2014年8月首都医科大学附属北京佑安医院术后病理活检证实为PCCCL的住院患者76例。采用免疫组化法检测癌组织CK19、P53、CD34、GPC-3和HepPar-1表达。应用Kaplan-Meier生存曲线和Wilcoxon检验分析CK19阳性与阴性的PCCCL患者的预后差异。结果在76例PCCCL组织中，CK19阳性9例（11.84%）；在肿瘤直径大于3 cm患者，CK19阳性患者发生肿瘤远端转移为60.0%（3/5），显著高于CK19阴性患者的8.7%（2/23,P＜0.05）；经Kaplan-Meier和Log-rank检验，结果显示CK19阴性的PCCCL患者生存期为60 w，显著长于CK19阳性的PCCCL患者（31 w，P＜0.05）。结论 PCCCL是一组异质性肿瘤,可以起源于CK19阳性的肝前体细胞,也可能转化自趋于分化成熟的肝细胞。PCCCL组织CK19阳性表达与患者的不良预后密切相关。
목적：탐토세포각단백19（CK19）재원발성간투명세포암（PCCCL）중적표체급기여환자예후적관계。방법수집2006년11월～2014년8월수도의과대학부속북경우안의원술후병리활검증실위PCCCL적주원환자76례。채용면역조화법검측암조직CK19、P53、CD34、GPC-3화HepPar-1표체。응용Kaplan-Meier생존곡선화Wilcoxon검험분석CK19양성여음성적PCCCL환자적예후차이。결과재76례PCCCL조직중，CK19양성9례（11.84%）；재종류직경대우3 cm환자，CK19양성환자발생종류원단전이위60.0%（3/5），현저고우CK19음성환자적8.7%（2/23,P＜0.05）；경Kaplan-Meier화Log-rank검험，결과현시CK19음성적PCCCL환자생존기위60 w，현저장우CK19양성적PCCCL환자（31 w，P＜0.05）。결론 PCCCL시일조이질성종류,가이기원우CK19양성적간전체세포,야가능전화자추우분화성숙적간세포。PCCCL조직CK19양성표체여환자적불량예후밀절상관。
Objective To investigate the expression of cytokeratin-19 (CK19) in primary liver clear cell carcinoma (PCCCL) and explore its implication for prognosis of patients with PCCCL. Methods The liver cancerous tissues from 76 individuals with HBV-associated PCCCL from 2006 to 2014 in Beijing You`An Hospital affiliated to Capital Medical University were retrospectively reviewed. The expressions of CK19,P53,CD34, glypican-3 (GPC-3),HepPar-1 were detected by immunohistochemistry staining. Kaplan-Meier survival curves and Wilcoxon test were used to assess the prognosis between CK19-positive and negative patients. Results 9 (11.84%) out of 76 patients with PCCCL were found CK19 positive in tumor tissues;When tumors were greater than 3 cm,a distant metastasis were 60.0%(3/5) in CK19 positive cases,which was much higher than 8.7%(2/23,P<0.05)in CK19 negative cases;The patients with CK19 negative had longer (60 weeks) survival times than in patients with CK19 positive (31 weeks,P<0.05) as showed by the Kaplan-Meier survival curves and Wilcoxon tests. Conclusion PCCCL consists of a heterogeneous origin,and it may transformed from CK19 positive hepatic progenitor cells in the process of differentiation and maturation. The expression of CK19 in PCCCL is closely associated with the poor prognosis of patients with PCCCL.