超重和肥胖患者肝细胞腺瘤微卫星不稳定性分析  

Analysis of microsatellite instability in hepatocellular adenoma cases with overweight and obesity

作　　者：付华辉[1,2] 金光植[2] 刘海平[2] 丛文铭[2] 

机构地区：[1]苏州大学医学部病理学与病理生理学系,江苏苏州215123 [2]第二军医大学东方肝胆外科医院病理科,上海200438

出　　处：《中华肿瘤防治杂志》2013年第20期1557-1560,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨超重/肥胖患者肝细胞腺瘤(hepatocellular adenoma,HCA)基因组微卫星不稳定性(microsatellite instability,MSI)的发生特点和临床病理学意义。方法:回顾性分析166例手术切除HCA患者的性别构成和体重指数(body mass index,BMI,kg/m2)等特点,采用石蜡切片显微组织切割基础上的单链构象多态性(PCR-SSCP)检测方法,选取与脂肪代谢、糖代谢、肥胖和雌激素代谢通路相关的5个基因相连锁的12个微卫星,随机对其中60例HCA患者,包括34例超重/肥胖患者的HCA组织中进行微卫星MSI检测。结果:在166例HCA中男114例,女52例。154例有完整BMI数据的HCA患者中超重/肥胖患者53.9%(83/154),其中男74例(89.2%),女9例(10.8%),男性患者的BMI平均为(25.78±0.75)kg/m2显著高于女性的(21.70±0.81)kg/m2,P=0.001。34例超重/肥胖患者HCA中,微卫星D12S1398发生MSI-H的频率为75.0%,显著高于MSI-L的31.2%,P=0.013;D6S1064发生MSI-H的频率为78.5%,显著高于MSI-L的33.3%,P=0.020。结论:与西方国家报道的HCA患者不同,中国HCA的发生以男性超重/肥胖患者多见,其发生可能与HNF-1α(D12S1398)和HIPPO(D6S1064)等代谢通路紊乱有关。微卫星MSI检测有助于临床了解HCA可能的病因和发生机制以及基因组不稳定性程度。OBJECTIVE： To study the characteristics of microsatellite instability （MSI） and clinicopathological sig nificance in overweight/obese patients with hepatocellular adenomas （HCA）. METHODS： The clinicopathological parame ters,including gender and body mass index （BMI,kg/m2） in 166 patients who underwent surgical resection for HCA were retrospectively analyzed. By using paraffin-section based microdesseetion-PCR-SSCP technology, 12 microsatellites link- aged with 5 genes which were related with fat metabolism, glucose metabolism, obese and estrogen metabolic pathways were detected for MSI in 60 randomly selected HCA, including 34 overweight/obese patients. RESULTS： Of the 166 HCA, 114 cases （68.44%） were male and 52 cases （31.6%） were female. Of the 154 patients with HCA,who had the da ta of body mass index （BMI, kg/m2 ）, overweight/obese patients accounted for 53.9 % （n = 83）, among them, 89.2 % （n = 74） were male and 10.8% （n=9） were female. The BMI in male and female patients were （25.78±0.75） kg/m2 and （21.70±0.81） kg/m2 ,respectively （P=0. 001）. Of the 12 microsatellites,the frequency of MSI at D12S1398 （75.0% for MSI-H,31.2O/oo for MSI-L） and D6S1064 （78.5%for MSI-H,33.3% for MSI-1） were significantly increased in 34 over-weight/obese patients with HCA （P=0. 013 and P=0. 020）. CONCLUSION： Different from patients with HCA reported in Western countries,Chinese patients with HCA are mainly seen in male overweight /obese patients. MSI analysis sug gests that the pathogenesis of Chinese HCA may be associated with metabolic pathway disturbances,especially including HNF-I inactivated pathway （D12S1398） and HIPPO pathway （D6S1064）. MSI determination is useful to understand the pathogenesis,mechanism and the degree of genomic instability of HCA.

关 键 词：肝肿瘤 腺瘤 肝细胞 微卫星不稳定 超重 肥胖 

分 类 号：R735.7[医药卫生—肿瘤]