半乳糖凝集素-4蛋白表达与巨大肝癌术后早期复发转移的关系及数学预测模型的研究  

Galectin-4 expression in early recurrence and/or metastasis after surgery of huge hepatocellular carcinoma, and study of mathematical prediction model

作　　者：曾金华[1] 黄新辉[2] 刘景丰[1] 曾永毅[1] 刘小龙[3] 黄尧[1] 

机构地区：[1] 福建医科大学附属第一医院肝病中心肝外科,福州350000 [2] 福建医科大学孟超肝胆医院肝胆胰外科 [3] 福建医科大学孟超肝胆医院肝病研究中心

出　　处：《中华实验外科杂志》2015年第4期883-886,共4页Chinese Journal of Experimental Surgery

基　　金：福建省自然科学基金资助项目（2014J01389）;2013年国家临床重点专科建设项目-肝脏外科

摘　　要：目的 探讨半乳糖凝集素（Galectin）-4蛋白在巨大肝癌中的表达及与术后早期复发转移的关系,并建立蛋白数学预测模型.方法 采用构建组织芯片结合免疫组织化学方法检测Galectin-4蛋白在73例巨大肝癌术后1年内复发转移与73例未复发转移的癌组织及配对的癌旁组织和10例正常肝组织中的表达,结合临床病理因素进行多因素分析及建立数学预测模型.结果 Galectin-4在巨大肝癌组织中阳性表达率为39.0％（57/146）,明显低于癌旁组织的71.9％（105/146,P＜0.05）和正常肝组织的80.0％（8/10,P＜0.05）;Galectin-4在12个月内复发转移组阳性表达率为19.1％ （14/73）,明显低于未复发转移组的58.9％ （43/73,P＜0.05）;Kaplan-Meier生存曲线分析显示Galectin-4阴性表达组1年无瘤生存率（53.1％）明显低于阳性表达组（83.6％,P＜0.05）.多因素分析显示,性别、Galectin-4表达、分化程度及镜下脉管癌栓是术后12个月发生复发转移的独立危险因素;由此建立的数学预测模型P=1/[1 ＋Exp（2.963＋性别的B值＋分化程度的B值＋镜下脉管癌栓的B值＋ Galectin-4蛋白表达的B值）],其灵敏度为65.75％,特异度为83.56％,准确度为74.66％.结论 Galectin-4蛋白低表达与巨大肝癌术后早期复发转移有关,建立的数学预测模型具有较高的准确率,可为巨大肝癌术后个体化预测提供依据.Objective To investigate the expression of galectin-4 protein in huge hepatocellular carcinoma （HCC） and its correlation with recurrence and/or metastasis after surgery,and to establish the mathematical prediction model.Methods The techniques of tissue microarray and immunohistochemical staining were employed to examine the expression profiles of galectin-4 in specimens （both carcinoma tissues and peri-carcinoma tissues） collected from the 73 patients with recurrence/metastasis （≤ 12 months） of HCC,and 73 patients with non-recurrent/metastasis HCC,and those in 10 healthy liver tissues.In addition,the implications of galectin-4 and its correlations with other clinicopathological parameters and recurrence/metastasis were also studied.Results The positive rate of galectin-4 in the carcinoma tissues was 39.0% （57/146）,significantly lower than that in the peri-carcinoma tissues （71.9%,105/146,P 〈0.05） and the healthy liver tissues （80.0%,8/10,P 〈0.05）.Galectin-4 protein was expressed in 19.1% （14/73） of the carcinoma tissues in the recurrence （≤ 12 months） group,and in 58.9% （43/73） in the non-recurrence group （P〈 0.05）.Kaplan-Meier survival curve analysis showed that the 1-year disease free survival rate in the negative expression of galectin-4 （53.1%） was significantly lower than that in the positive group （83.6%,p 〈 0.05）.Multivariate analysis showed that gender,galectin expression,differentiation and microscopic vascular invasion was independent risk factors for postoperative recurrence （12 months）.A mathematical prediction model was established：P =1/[1 ＋ Exp （2.963 ＋ sex of B value ＋ differentiation of B value ＋ B value of microscopic vascular invasion ＋ Galectin-4 protein expression in B value）].The sensitivity,specificity and accuracy for prediction of HCC recurrence （12 months） was 65.75%,83.56%,and 74.66% respectively.Conclusion Galectin-4 expression may be associated with early recurrence and/or metastasis after surgery in hu

关 键 词：半乳糖凝集素-4 巨大肝癌 转移 数学模型 Galectin-4 

分 类 号：R735.7[医药卫生—肿瘤]