游经宏,周凯,黄品助
YOU Jinghong,ZHOU Kai,HUANG Pinzhu

• 1:监利县人民医院普外科
• 2:江西省人民医院外科
• 3:中山大学附属第六医院结直肠外科

摘要(Abstract)：

目的:探讨癌旁肝组织蛋白磷酸酶2A癌性抑制因子(CIP2A)的表达对预测合并肉眼血管侵犯的肝癌患者术后预后的价值。方法:采用实时定量PCR及免疫组化方法分析368例肝癌患者癌旁无瘤肝组织中CIP2A mRNA和蛋白表达,根据有无肉眼血管侵犯和CIP2A mRNA表达水平分为血管侵犯CIP2A高表达组、血管侵犯CIP2A低表达组,无血管侵犯CIP2A高表达组、无血管侵犯CIP2A低表达组;结合患者的临床病理学特征及随访资料,比较4组肝癌患者CIP2A蛋白表达阳性率,3年和5年总生存率及无复发生存率;采用多因素Cox模型分析影响肝癌患者术后预后的独立危险因素,Kaplan-Meier法分析癌旁肝组织CIP2A的表达水平预测肝癌患者预后的价值。结果:血管侵犯组癌旁组织的CIP2A蛋白阳性率明显高于无血管侵犯组(P<0.05),血管侵犯组肝癌患者生存率及无复发生存率显著低于无血管侵犯组(P<0.01);在无血管侵犯组中,癌旁CIP2A mRNA低表达组总生存率及无复发生存率显著高于高表达组,在肉眼血管侵犯组中,癌旁CIP2A mRNA低表达组的1年、3年总生存率高于高表达组,差异有统计学意义(P<0.01)。结论:合并肉眼血管侵犯肝癌患者癌旁肝组织中CIP2A的表达水平可预测患者术后生存。
Objective: To investigate the expression of CIP2 A in adjacent tissues of liver cancer and its postoperative prognostic value in predicting HCC patients with macroscopic vascular invasion.Methods: Real-time quantitative PCR and immunohistochemical method were adopted to analyze CIP2 A expression in non-tumor liver tissue in 368 cases of HCC patients. According to macroscopic vascular invasion condition and expression of CIP2 A,the 368 cases were divided into macroscopic vascular invasion CIP2 A high expression group,macroscopic vascular invasion CIP2 A low expression group,non-macroscopic vascular invasion CIP2 A high expression group,non-macroscopic vascular invasion CIP2 A low expression group. According to the clinical pathological characteristics and follow-up data of the patients,the positive rate of CIP2 A protein expression,the overall survival rate and relapse free survival rate were compared between the 4 groups. Multivariate Cox model was used to analyze the independent risk factors affecting the prognosis of HCC patients,and Kaplan-Meier was used to analyze the value of detecting the expression of CIP2 A in the adjacent liver tissues to predict the prognosis of HCC patients. Results: The positive rate of CIP2 A in macroscopic vascular invasion group was significantly higher than that of non-macroscopic vascular invasion group(P < 0. 05). 3 years and 5 years overall survival rate and relapse free survival rate in macroscopic vascular invasion group were significantly lower than those of non-macroscopic vascular invasion group(P < 0. 01). In non-macroscopic vascular invasion group,3 years and 5 years overall survival rate and relapse free survival rate in CIP2 A low expression group were significantly higher those of CIP2 A high expression group,while in macroscopic vascular invasion group,1 year and 3 years overall survival rate and relapse free survival rate in CIP2 A low expression group were significantly higher than those of CIP2 A high expression group,and the differences were statistically significant(P < 0. 01). Conclusion: The expression level of CIP2 A in the adjacent liver tissues of patients with HCC combined with vascular invasion can be used to predict the survival of patients after surgery.

关键词(KeyWords)： 肝肿瘤;癌旁肝组织;肉眼侵犯;蛋白磷酸酶2A癌性抑制因子;预测
liver neoplasm;the liver tissue adjacent to carcinoma;macroscopic vascular invasion;cancerous inhibitor of protein phosphatase 2A;predicting

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81372571)

作者(Author): 游经宏,周凯,黄品助
YOU Jinghong,ZHOU Kai,HUANG Pinzhu

DOI: 10.19367/j.cnki.1000-2707.2017.05.015

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