HBV相关的原发性肝透明细胞癌组织CK19表达及其临床意义  

Expression of cytokeratin-19 in cancerous tissues of patients with hepatitis B-associated primary clear cell carcinoma of liver

作　　者：车睿雯 冯帅[1] 冯骥良[1] 刘巨超[1] 吕福东[1] 诸国华[1] 张士杰[1] 宋晨朝[1] 董昆[1] 廖孟涵 

机构地区：[1]首都医科大学附属北京佑安医院病理科,北京市100069

出　　处：《实用肝脏病杂志》2015年第6期633-637,共5页Journal of Practical Hepatology

基　　金：中国初级卫生保健基金会佑安肝病/艾滋病基金(编号:BJYAH-2011-071;BJYAH-2011-072);首都医科大学基础-临床科研合作基金(编号:15JL66)

摘　　要：目的探讨细胞角蛋白19（CK19）在原发性肝透明细胞癌（PCCCL）中的表达及其与患者预后的关系。方法收集2006年11月一2014年8月首都医科大学附属北京佑安医院术后病理活检证实为PCCCL的住院患者76例。采用免疫组化法检测癌组织CK19、P53、CD34、GPC-3和HepPar-1表达。应用Kaplan—Meier生存曲线和Wilcoxon检验分析CK19阳性与阴性的PCCCL患者的预后差异。结果在76例PCCCL组织中，CK19阳性9例（11．84％）；在肿瘤直径大于3cm患者，CK19阳性患者发生肿瘤远端转移为60．0％（3／5），显著高于CK19阴性患者的8．7％（2／23，P〈0．05）；经Kaplan—Meier和Log-rank检验，结果显示CK19阴性的PCCCL患者生存期为60W，显著长于CK19阳性的PCCCL患者（31W，P〈0．05）。结论PCCCL是一组异质性肿瘤，可以起源于CK19阳性的肝前体细胞，也可能转化自趋于分化成熟的肝细胞。PCCCL组织CK19阳性表达与患者的不良预后密切相关。Objective To investigate the expression of cytokeratin-19 （CK19） in primary liver clear cell carcinoma （PCCCL） and explore its implication for prognosis of patients with PCCCL. Methods The liver cancerous tissues from 76 individuals with HBV-associated PCCCL from 2006 to 2014 in Beijing You＇An Hospital affiliated to Capital Medical University were retrospectively reviewed. The expressions of CK19,P53,CD34, glypican-3 （GPC-3）,HepPar-1 were detected by immunohistochemistry staining. Kaplan-Meier survival curves and Wilcoxon test were used to assess the prognosis between CK19-positive and negative patients. Results 9 （11.84%） out of 76 patients with PCCCL were found CK19 positive in tumor tissues;When tumors were greater than 3 cm,a distant metastasis were 60.0%（3/5） in CK19 positive cases,which was much higher than 8.7%（2/ 23,P〈0.05）in C K19 negative cases;The patients with C K19 negative had longer （60 weeks） survival times than in patients with CK19 positive （31 weeks,P〈0.05） as showed by the Kaplan-Meier survival curves and Wilcoxon tests. Conclusion PCCCL consists of a heterogeneous origin,and it may transformed from CK19 positive hepatic progenitor cells in the process of differentiation and maturation. The expression of CK19 in PCCCL is closely associated with the poor prognosis of patients with PCCCL.

关 键 词：肝透明细胞癌 细胞角蛋白19 预后 

分 类 号：R735.7[医药卫生—肿瘤]