出血性铁过载对肝癌组织中Kupffer细胞分布的影响及其意义  

Significance of Kupffer cells distribution reduction caused by hemorrhagic iron overload in hepato- cellular carcinoma

作　　者：邓小荣[1] 李强[1] 万红萍[1] 何玉麟[1] 付玉花 余俐敏 王正选 苏健 

机构地区：[1]南昌大学第一附属医院普外科,330006 [2]鹰潭市人民医院普外科

出　　处：《中华实验外科杂志》2012年第10期1921-1922,共2页Chinese Journal of Experimental Surgery

基　　金：江西省鹰潭市科技支撑计划资助项目（2009）

摘　　要：目的探讨出血性铁过载对肝癌组织中Kupffer细胞（KC）分布的影响及其意义。方法分析143例肝癌手术患者癌灶体积大小、是否合并出血、计算出血率；采用随机对照试验收集15例肝癌合并癌灶出血患者（出血组），10例未合并癌灶出血患者的资料（非出血组）。采用普鲁士蓝反应（铁染色）检测出血组与非出血组患者的肝癌组织中铁分布；采用免疫组织化学链霉素抗生物素蛋白一过氧化酶连接法（SP法）等技术检测癌组织中转铁蛋白受体（TfR）及KC表面CD68表达，图像分析仪确定其表达量。结果143例肝癌患者合并出血的36例，出血率为25％，瘤体平均直径大于6cm；出血组肝癌组织中铁染色阳性吸光度值明显高于非出血组（0．87±0．21比0．43±0．15，P〈0．01），而且TfR表达也明显高于非出血组（0．31±0．08比0．14±0．05，P〈0．01），导致出血性铁过载；而出血组肝癌中KC的CD68表达减少，明显低于非出血组（0．18±0．03比0．32±0．06，P〈0．05）；出血组肝癌组织中铁过载与KC分布减少呈正相关（r=0．815，P〈0．01）。结论肝癌出血性铁过载形成高铁胁迫微环境．伴有KC分布减少。从而影响KC的抗肝癌作用。Objective To investigate the significance of Kupffer cells （KC） distribution changes caused by iron overload in hepatocellular carcinoma （HCC） with haemorrhage. Methods＇ From June 2005 to June 2010, 143 cases of HCC operated in the first affiliated hospital of Nanchang University were analyzed retrospectively according to lesion diameter, with or without haemorrhage, We randomly collected 15 specimens from HCC with haemorrhage （bleeding group） and 10 specimens without haemorrhage （non- bleeding group）. Prussian blue reaction （iron staining） was used to detect the distribution of iron in the tissues of HCC. Immunohistoehemistry （streptavidin-biotin peroxidase method） was used to detect the expression of transferrin receptor （TfR） in the tissues of HCC and the expression of CD68 in KC. The expression amount was determined by usign image analyzer. Results Thirty-six of 143 cases （25%） were complicated with hemorrhage, with average diameter greater than 6 cm. The iron staining positive rate and the expression of TfR in the tissues of bleeding group were significantly higher （0. 87 ＋0. 21 and 0. 31 ±0. 08 respectively） than in non2bleeding group （0. 43 ±0. 15 and 0. 14 ±0. 05 respectively） （for each P 〈 0. 01 ）, causing hemorrhagic iron overload. On the contrary, the expression of CD68 in KC of bleeding group （0. 18 ± 0. 03 ） was obviously lower than that in non-bleeding group （0. 32 ± 0.06） （P 〈 0.05 ）. There was a marked Correlation between iron staining and the distribution reduction of KC in bleeding group （r = 0. 815 ,P 〈 0. 01 ）. Conclusion HCC with bleeding causes hemorrhagic iron overload and excessive ferrousion stress, accompanying the distribution reduction of KC. It indicates that the anticancer effect of KC in HCC may be influenced.

关 键 词：癌 肝细胞 KUPFFER细胞 铁过载 

分 类 号：R735.7[医药卫生—肿瘤]