过氧化物酶体增殖物活化受体γ与肝癌瘤内微循环的关系  

The association of expression of peroxisome proliferator-activated receptor γ with microcirculation of intra-hepatocellular carcinoma

作　　者：吴旭东[1] 陈卫昌[2] 张素青[2] 

机构地区：[1]苏州大学附属第一医院消化内科,苏州215006 [2]南通市肿瘤医院普外科,南通226361

出　　处：《肿瘤》2007年第11期894-898,共5页Tumor

摘　　要：目的:观察过氧化物酶体增殖物活化受体γ(peroxisome proliferator-activated receptorγ,PPARγ)与肝细胞癌(hepato-cellular carcinoma,HCC)微血管密度(microvessel density,MVD)和血管生成拟态(vasculogenic mimicry,VM)的关系,并探讨它们在HCC中的临床意义。方法:应用CD34免疫组织化学染色和过碘酸雪夫反应(PAS)与CD34复合染色检测34对手术切除HCC和癌旁组织标本的PPARγ、MV和VM表达,结合患者临床病理特征进行分析。结果:PPARγ在24/34例HCC中高表达,与肿瘤>5 cm(P=0.027)、包膜不完整(P=0.014)、转移复发倾向(P=0.001)相关;癌组织中MVD高于对应癌旁组织(P<0.05);高MVD与肿瘤>5 cm(P=0.010)、有无包膜(P=0.001)、转移复发倾向(P=0.004)、随访有无转移(P=0.008)和分化程度(P=0.001)有关;7/34例HCC中发现VM存在,VM阳性组MVD高(P<0.05);VM阳性与临床分期(P=0.001)、复发倾向(P=0.029)和分化程度(P=0.004)相关。PPARγ阳性表达与高MVD成正相关(r=0.519);PPARγ阳性、高MVD和VM阳性可判断患者生存率,log-rank检验P值分别为0.013,0.036和0.022。COX风险模型分析PPARγ阳性和高MVD均是独立预测HCC预后的因子。结论:PPARγ与肝癌瘤内微循环形成有关,PPARγ可作为评估肝癌患者预后的新的重要指标。Objective： To observe the association of the expression of peroxisome proliferator-activated receptor γ （PPARγ） with microvessel density （MVD） and vascularization mimicry （VM） in hepatocellular carcinoma （HCC） and explore their clinical significance. Methods： Thirty-four cases of HCC confirmed by pathological examination between 2003 and 2006 in Nantong Tumor Hospital were recruited in this study. The expressions of PPARγ, MVD and VM were tested by CD34 immunohistochemical （IHC） staining and seriodic acid-schiff （PAS） reaction in 34 cases of HCC tissues and its paired non-cancerous tissues. Their biological behaviors were analyzed and associated with the clinicopathological features. Results： PPARγ： was over-expressed （24/34） in HCC tissue. It was associated with tumor size （ 〉 5 cm, P = 0.027）, broken capsule （P = 0.014）, tendency to metastasis and recurrence （P = 0.001 ）. The MVD was higher （23/24） in HCC tissue than that in corresponding para-cancerous tissues （P 〈 0.05 ）. High MVD was related with tumor size （ 〉 5 cm, P = 0.010）, broken capsule （P = 0. 001 ）, tendency to metastasis and recurrence （P = 0.004）, with or without metastasis during follow- up period （ P = 0. 008）, and differentiation degree （ P = 0.001 ）. The positive expression of VM was detected in 7 out of 34 HCC tissues. The MVD was higher in VM-positive group （ P 〈 0.05 ）. The positive expressions of VM were associated with TNM stage （ P = 0.001 ）, tendency to recurrence （ P = 0.029 ） , and differentiation degree （ P = 0. 004 ）. There was a significantly positive correlation between the over-expression of PPARγ and high MVD （ r = 0. 519 ）. Kaplan-Meier analysis indicated that positive expression of PPARγ and VM as well as high MVD could be used for predicting the survival rate of HCC patients （ P = 0. 013, 0.036 and 0.022, log-rank test）. Cox hazard model analysis showed that positive PPARγ expression and high MVD were the indepen

关 键 词：肝肿瘤 PPARΓ 新生血管化 病理性 预后 

分 类 号：R735.7[医药卫生—肿瘤]