Glypican-3、TNF-α在原发性肝细胞癌中的表达及其与预后的关系  

The expression of Glypican-3, TNF alpha in primary hepatocellular carcinoma and its influence on prognosis

作　　者：陈春洲[1] 龙浩成[1] 雷长江[1] 李磊[1] 曾诚[1] 黄剑彬[1] 

机构地区：[1]江汉大学第二附属医院普外科,武汉430050

出　　处：《中华临床医师杂志（电子版）》2015年第8期32-36,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：武汉市科技局应用基础研究项目(2013062301010823);武汉市卫计委医疗科研项目(WX14A11)

摘　　要：目的探讨磷脂酰肌醇蛋白-3(GPC-3)、肿瘤坏死因子α(TNF-α)在原发性肝细胞癌(HCC)患者血清中的水平及其对预后的影响。方法选择2010年1月至2013年12月期间60例原发性肝癌患者为研究对象。60例原发性肝癌中原发性HCC 40例,原发性肝内胆管细胞癌20例。40例患者按HCC临床分期:早期HCC 18例,中晚期HCC 22例;按HCC预后好坏:死亡(预后不良组)8例,存活(预后较好组)32例。选择30例肝硬化患者为疾病对照组,选择健康者60例为对照组。统计受试者血清GPC-3、TNF-α水平,并对血清GPC-3、TNF-α与年龄、预后、HCC临床分期、肝癌病理类型、BMI进行相关性分析。结果 HCC组血清GPC-3、TNF-α水平高于肝硬化组和对照组,差异有统计学意义(P<0.01),肝硬化组和对照组血清GPC-3、TNF-α水平无明显差异(P>0.05);不同病理类型肝癌之间血清GPC-3、TNF-α水平存在明显差异,HCC组血清GPC-3、TNF-α水平高于肝内胆管细胞癌组和健康对照组,差异有统计学意义(P<0.01),肝内胆管细胞癌组和对照组血清GPC-3、TNF-α水平无明显差异(P>0.05);中晚期、早期HCC患者血清GPC-3、TNF-α水平存在明显差异。随着HCC的进展,血清GPC-3、TNF-α水平呈上升趋势,且中晚期、早期、对照组三组间两两比较均有统计学差异(P<0.01);不同预后HCC患者血清GPC-3、TNF-α水平存在明显差异,预后不良组患者血清GPC-3、TNF-α水平高于预后较好组,且预后不良组、预后较好组、对照组三组间两两比较均有统计学差异(P<0.01);血清GPC-3、TNF-α水平与HCC临床分期、肝癌病理类型均呈正相关(P<0.05);血清GPC-3、TNF-α水平与HCC预后均呈负相关(P<0.05);血清GPC-3、TNF-α与年龄、BMI等因素无明显相关性(P>0.05)。结论 GPC-3、TNF-α在HCC患者血清中呈现高表达,GPC-3、TNF-α的表达与HCC发病、进展及预后密切相关。Objective To study expression of Glypican-3, TNF alpha in primary hepatocellular carcinoma （HCC） and its influence on prognosis. Methods Between January 2010 and December 2013, the 60 cases of primary liver cancer patients were selected as the research object. 60 cases of primary liver cancer, 40 cases of primary HCC, 20 cases of primary intrahepatic bile duct carcinoma were selected. 40 cases of HCC according to the clinical stages：the early HCC 18 example, middle-late HCC 22 cases were selected; According to the prognosis of HCC is good or bad： death group （prognosis） were 8 cases, 32 cases were live better prognosis （group）. Chose for 30 patients with cirrhosis of the liver disease control group, chose 60 cases of healthy subjects as control group. Statistical subjects were GPC-3, serum TNF alpha level, and to the GPC-3, serum TNF alpha and age, course of the disease, HCC, liver pathological type, clinical stage BMI for correlation analysis. Results HCC group of GPC-3, serum TNF alpha level were higher than that of liver cirrhosis group and the control group, the difference was statistically significant （P〈0.01）, in liver cirrhosis group and the control group the GPC-3, serum TNF alpha level had no obvious difference （P〉0.05）; Between different pathological type of liver cancer GPC-3, serum TNF alpha level existed obvious difference, HCC group of GPC-3, serum TNF alpha level were higher than that of intrahepatic bile duct carcinoma group and healthy control group, the difference was statistically significant （P〈0.01）, in intrahepatic bile duct carcinoma group and the control group the GPC-3, serum TNF alpha level had no obvious difference （P〉0.05）; in middle-late, early HCC patients serum GPC-3, TNF alpha level existed significant differences. With the progress of the HCC, GPC-3, serum TNF alpha level was on the rise, and in the early period, two comparison between the three groups were statistically significant （P〈0.01）;in different prognosis of HCC patients serum

关 键 词：癌 肝细胞 磷脂酰肌醇类 肿瘤坏死因子Α 预后 

分 类 号：R735.7[医药卫生—肿瘤]