肝切除术后血清高尔基体蛋白73的变化与肝癌复发的关系  

Changes of serum GP73 after hepatectomy and its relationship with recurrence in hepatocellular carcinoma patients

作　　者：杨华瑜[1] 孙永亮[1] 毛一雷[1] 徐海峰[1] 张锦春[1] 卢欣[1] 桑新亭[1] 钟守先[1] 

机构地区：[1]中国医学科学院北京协和医院肝脏外科,100730

出　　处：《中华普通外科杂志》2012年第2期115-118,共4页Chinese Journal of General Surgery

摘　　要：目的探讨肝血管瘤和肝癌行肝切除术后的血清高尔基体蛋白73（Golgimembraneprotein73，GP73）变化趋势及其与肝癌复发、患者预后生存间的联系。方法采用Westernblot定量测定61例手术切除的肝血管瘤和65例肝癌患者术前、术后GP73，并在肝癌组患者中临床诊断肝癌复发时监测GP73变化。结合患者的临床资料及生存预后观察GP73能否作为判断预后的指标。结果肝血管瘤患者术前及术后各时间点间GP73值差异无统计学意义。肝癌组患者术前GP73值为9．9（3．7～15．8）RU，术后3、7、14dGP73值分别为9．1（3．4—13．3）RU，4．3（1．7—9．0）RU，3．3（2．1—5．4）RU，各时间点间比较差异有统计学意义（F=72．606，P〈0．001）。肝癌组患者中21例复发，复发者术前GP73值为9．9（2．9～15．O）RU，复发时GP73值为11．0（8．4—13．8）RU，两者间差异无统计学意义（Z=1．185，P〉0．05）。未复发肝癌44例，术前GP73值为10．5（3．9—16．1）RU，与复发者相比差异无统计学意义（Z=-1．546，P〉0．05）。结论肝癌切除导致GP73的下降，肝癌复发伴随着GP73水平上升，GP73可以作为肝癌术后复发的监测指标。Objectives To investigate changes of GP73 after hepatectomy and its correlations with hepatoeellular carcinoma （HCC） recurrence. Methods Perioperative serum GP73 was monitored in hepatic hemangioma and HCC patients undergoing hepatectomy. Clinicopathologic features and follow-up results were collected to evaluate the relationship between serum GP73 level and patients＇ prognosis. Results There was no statistical difference between preoperative GP73 and postoperative GP73 in hepatic hemangioma group. While preoperative GP73 in HCC group was 9. 9（3.7 - 15.8） relative unit （RU）, and that on POD3 （ postoperative day 3 ） was 9. 1 （ 3.4 - 13.3 ） RU, on POD7 was 74. 3 （ 1.7 - 9. 0 ） RU, on POD14 was 3. 3 （2. 1 - 5.4） RU （ F = 72. 606, P 〈 0. 001 ）. HCC recurred in 21 eases during follow-up, GP73 in recurrent cases [ 11.0 （ 8.4 - 13.8 ） RU ] was significantly higher than postoperative trough values while it was not different from their preoperative GP73 level [ 9. 9 （ 2. 9 - 15.0 ） RU ] （ Z = 1. 185, P 〉 0. 05）. The preoperative GP73 level between recurrent subgroup and nonrecurrent subgroup was not significantly different （Z = - 1. 546, P 〉 0. 05 ）. Preoperative GP73 did not correlate to patients＇ survival. Conclusions Hepatectomy for HCC leads to a significant decrease of GP73 and postoperative HCC recurrence accompanies reelevation of GP73. GP73 could be used as a postoperative monitor for HCC reeurrenee.

关 键 词：癌 肝细胞 肿瘤蛋白质类 肿瘤复发 局部 高尔基体蛋白73 预后 

分 类 号：R735.7[医药卫生—肿瘤]