肝细胞癌中HBx蛋白表达对间歇肝门血流阻断技术肝切除预后的影响  

Prognostic value of the expression of HBx protein in hepatocelluar carcinoma in liver resection using Pringle maneuver

作　　者：吕文平[1] 陈劲松[2] 陈永亮[1] 周开伦[2] 苏明[1] 千年松[1] 董家鸿[1] 

机构地区：[1]解放军总医院海南分院肝胆外科,三亚572013 [2]海南省人民医院肝胆外科,571000

出　　处：《中华普外科手术学杂志（电子版）》2012年第4期27-29,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金资助项目(30772493);中国博士后科学基金特别资助项目(200801063)

摘　　要：目的探讨肝细胞癌HBx蛋白表达对间歇肝门血流阻断技术(Pringle法)肝切除预后的影响。方法对根治性肝切除234例肝细胞癌,石蜡组织制备组织芯片,免疫组织化学采用Envision二步法,统计分析HBx蛋白表达对Pringle法肝切除预后影响。结果 Pringle法肝切除组168例(71.8%),HBx蛋白阳性表达48.2%(81/168);非Pringle法肝切除组66例(28.2%),HBx蛋白阳性表达53.0%(35/66),二组比较差异无统计学意义(P>0.05)。Pringle法肝切除组术后1、3、5年存活率分别是69.1%、42.3%、28.3%;非Pringle法肝切除组术后1、3、5年存活率分别是71.2%、37.8%、30.5%,二组比较差异无统计学意义(P>0.05)。Pringle法肝切除组:HBx蛋白阳性表达亚组1、3、5年存活率分别是50.6%、33.9%,23.2%;HBx蛋白阴性表达亚组术后1、3、5年存活率分别是86.2%、50.5%,33.3%,二者比较差异有统计学意义(P<0.01);非Pringle肝切除法组:HBx蛋白阳性表达亚组术后1、3、5年存活率分别是71.4%、36.0%,32.2%;HBx蛋白阴性表达亚组术后1、3、5年存活率分别是73.3%、41.5%,26.9%,二者比较差异无统计学意义(P>0.05)。结论 Pringle法不影响肝细胞癌肝切除的预后,但HBx蛋白表达可以导致Pringle法肝细胞癌肝切除术后预后不良。Objective To investigate the prognostic value of the expression of HBx protein in hepatocelluar carcinoma during hepatectomy by using Pringle maneuver.Methods Paraffin-embedded specimens of 234 patients with HCC who underwent curative liver resection From January 1991 to June 2002 and liver samples from 18 healthy adults at our department were used for tissue microarray.Immunohistochemical technique（EnVisionTM） was applied to detect the expression of HBx protein.The prognostic value of HBx protein in Pringle maneuver during hepatectomy was analyzed statistically.Results In 168（71.8%） patients in hepatectomy with Pringle maneuver group（HPM group）,the positive rate of HBx expression was 48.2%（81/168）.In 66（28.2%） patients in the hepatectomy without Pringle maneuver group（non-HPM group）,the positive rate of HBx expression was 53.0%（35/66）.There was no significant difference between the two groups（P0.05）.The 1-,3-,5-year survival rates were 69.1%,42.3%,28.3% in the HPM group,and 71.2%,37.8%,30.5% in the non-HPM group（P0.05）,respectively.In the HPM group,the 1-,3-,5-year survival rates were 50.6%,33.9%,23.2% respectively in HCC patients with positive HBx and 86.2%,50.5%,33.3% respectively in HCC patients with negative HBx（P0.01）.In the non-HPM group,the 1-,3-,5-year survival rates were 71.4%,36.0%,32.2% respectively in HCC patients with positive HBx and 73.3%,41.5%,26.9% respectively in HCC patients with negative HBx（P0.05）.Conclusions Pringle maneuver may not affect the long term outcome of hepatectomy in treating HCC;however HBx protein expression may be a poor prognostic factor.

关 键 词：癌 肝细胞 肝切除术 预后 肝炎病毒x 乙型 蛋白 

分 类 号：R735.7[医药卫生—肿瘤]