肿瘤干细胞表面标志物CD133在肝细胞肝癌组织中的表达及其与肝移植患者预后的关系  

Expression of CD133 as a tumor stem cell surface marker in hepatocellular carcinoma and its significance in the prognosis of liver transplantation patients

作　　者：曾宪成[1,2] 张彤[1] 傅斌生[1] 陈伟[3] 陈冠中[1] 李华[1] 张琪[1] 杨扬[1] 陈规划[1] 

机构地区：[1]中山大学器官移植研究所中山大学附属第三医院肝移植中心,广州511300 [2]广东省增城市人民医院(中山大学附属博济医院)普通外科 [3]浙江大学医学院附属第二医院普通外科

出　　处：《中华肝脏外科手术学电子杂志》2012年第1期48-52,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：国家重点基础研究发展规划(国家973规划)资助项目(2009CB522404);教育部博士点基金(20100171120087);广东省自然科学基金(10451130001004472);广东增城市科技创新扶持基金(ZC201004)

摘　　要：目的探讨肿瘤干细胞表面标志物分化群抗原（CD）133在肝细胞肝癌（肝癌）组织中的表达及其与肝移植患者预后的关系。方法本回顾性研究的109例肝癌组织标本来源于2004年1月至2007年12月在中山大学附属第三医院肝移植中心施行同种异体原位肝移植，组织病理学检查证实为肝癌的手术切除标本，另取41例肝穿刺正常肝组织作为正常对照。收集109例肝癌患者的临床病理学资料，并对其进行术后随访，收集患者存活时间，肿瘤复发、转移及死亡情况的随访资料。所有患者均签署知情同意书，符合医学伦理学规定。应用免疫组织化学方法检测109例肝癌组织和41例正常肝组织中CD133的表达水平，分析CD133阳性表达与患者年龄、性别、甲胎蛋白（AFP）、外周血中性粒细胞与淋巴细胞比值（NLR）、肿瘤直径、肿瘤数量、分化程度、血管侵犯等肝癌临床病理学参数的关系。应用Kaplan—Meier法计算患者移植后存活率，应用Log—rank检验比较各参数对存活率的影响。结果全组肝癌患者均接受随访，随访时间6～77个月。随访期间肿瘤复发37例，复发部位分别为肝内24例、肺部6例、腹腔3例、全身多发性转移或骨转移4例。随访期间死亡40例，分别死于肿瘤复发35例、胆道并发症3例、肺部感染和急性粒细胞白血病各1例。肝癌组织中CD133阳性表达44例，阳性率为40．4％，正常肝组织无CD133表达，比较差异有学意义（P〈0．01）。CD133阳性表达与肿瘤直径、肿瘤分化程度有关（均为P〈0．05）。CD133阳性组患者肝移植的1、3、5年存活率明显低于CD133阴性组患者（χ2=8．008，P〈0．05）。结论肝癌组织存在CD133表达，CD133阳性表达的肝癌肝移植患者预后较差。Objective To investigate the expression of cluster of differentiation （CD） 133 in hepatocellular carcinoma （HCC） and its significance in the prognosis of patients with HCC undergoing liver transplantation. Methods One hundred and nine HCC tissue samples were collected and analyzed retrospectively from patients undergoing orthotopic liver transplantation for HCC and the pathological diagnosis of HCC was confirmed by histopathology in liver transplantation center of the Third Affiliated Hospital of Sun Yat-sen University from January 2004 to December 2007. Forty-one normal liver tissue samples were collected as control from liver puncture. Clinical pathological data of 109 HCC patients and follow-up data including survival time, tumor recurrence, metastasis and death were collected. Local ethical committee approval had been received and that the informed concent of all participating suhjeets was obtained. The expression of CD133 was detected by immunohistochemical method in 109 HCC and 41 normal liver tissues, and the relationship between the expression of CD133 and clinieopathologieal parameters such as ages, sex, alpha-fetoprotein, peripheral blood neurophil to lymphocytes ratio, tumor diameter, tumor number, tumor differentiation degree as well as vascular invasion was analyzed. Results All the patients were followed up and the follow-up period was from 6 to 77 months. Among 109 eases, 37 patients （33.9%） developed tumor recurrence, 24 eases with tumor reeurrence in the liver, 6 in the lung, 3 in the abdominal cavity, 4 cases with systemic muhiple metastases or bone metastases. Forty patients died during follow-up, among which 35 patients died of tumor recurrence, 3 eases of biliary complications, 1 case of pulmonary infection and 1 case of acute myeloid leukemia. The positive rate of CD133 expression was 40.4%（44/109） in HCC samples, but the expression of CD133 was not detected in normal liver tissue. There was significant difference between two groups （P〈0.01）. There was relationship betw

关 键 词：肝细胞肝癌 肝移植 分化群抗原133 干细胞表面标志物 预后 肿瘤复发 

分 类 号：R735.7[医药卫生—肿瘤]