肝癌根治术后早期肺转移临床因素及CXCR7蛋白数学预测模型的研究  

The Establishment of the Mathematical Prediction Model Linked to Cinically Relevant Factors and CXCR7 after Curative Hepatic Resection

作　　者：王先明[1] 王斌[2] 曾永毅[1] 池闽辉[1] 黄尧[1] 黄爱民[2] 刘景丰[1] 

机构地区：[1]福建医科大学第一临床医学院,附属第一医院肝病中心,福州350005 [2]福建医科大学病理系,福州350004

出　　处：《福建医科大学学报》2012年第3期173-176,共4页Journal of Fujian Medical University

基　　金：福建省科技厅社会发展重点项目(2011Y0022);福建省自然科学基金(2011J01162);福建省属高校基金(JK2011021)

摘　　要：目的探讨建立肝癌根治术后早期肺转移临床因素及CXCR7蛋白数学预测模型。方法收集根治性切除279例患者的肝癌组织、癌旁组织标本及14例正常肝组织构建组织芯片,利用免疫组织化学方法检测CXCR7蛋白在肝癌组织、癌旁组织及正常肝脏组织中的表达情况;回顾性分析279例患者的临床资料,以10项相关的临床病理因素及肝癌细胞中CXCR7蛋白表达情况进行单因素分析,筛选相关影响因素,并进行多因素分析及建立术后肺转移的预测模型。结果术后1年肺转移发生率为12.9%(36/279)。单因素分析提示肺转移组和无肺转移组在CXCR7蛋白表达、性别、肿瘤大小、术前AFP、镜下脉管癌栓方面相比较有显著性差异。多因素分析提示术后发生肺转移的独立判断因素为CXCR7蛋白阳性表达、肿瘤大小。结论随着肿瘤直径增大、CXCR7蛋白阳性表达,患者术后早期肺转移可能性较大。本预测数学模型P=Y/(1+Y),Y=EXP(-6.676+肿瘤大小的B值+CXCR7蛋白表达的B值)具有较高的预测准确率。Objective To investigate the establishment of the mathematical prediction model linked to clinically relevant factors and CXCR7 after curative hepatic resection. Methods Tissue mi- croarrays was constructed,among these patients, the expression of protein were evaluated by immunohis- tochemical method in 279 HCC. The hepatocelluar carcinoma patients who received radical operation were investigated retrospectively. A single factor analysis was performed to find the risk factors pulmo- nary metastasis after curative hepatic resection. And a multivariate logistic regression analysis was per- formed according to the relevant clinical and pathology factors and CXCR7 to establish the prediction equa- tion of early pulmonary metastasis Results The ratio of pulmonary metastasis of hepatocelluar carcinoma after curative hepatic resection in 1 year was 12.9%（36/279）. According to single factor analysis, the in- dicators, including the tumor diameters, the level of AFP,microvascular invasion by the microscope exami- nation,the expression of CXCR7 were different significantly in two groups. The multivariate logistic re- gression analysis indicated that the independent prognostic factors of pulmonary metastasis of hepatocelluar carcinoma after curative hepatic resection was the expression of CXCR7 and the tumor diameters. Conclusions The patients whose tumor expressed CXCR7 protein, and tumor diameter was more than others was prone to pulmonary metastasis after curative hepatic resection. Clinical vertification indicates that the prediction equation is credible.

关 键 词：癌 肝细胞 肝肿瘤 肺肿瘤 肿瘤转移 蛋白质类 模型 理论 数学 免疫组织化学 

分 类 号：R735.7[医药卫生—肿瘤]