肝移植受体补体C7基因多态性与肝癌肝移植术后复发的关联  

Association between recipient C7 gene polymorphisms and the risk of hepatocellular carcinomarecurrence following liver transplantation

作　　者：童伟民 王普森 李浩[2] 王春光[2] 史宝洁 樊军卫[2] 彭志海[2] 钟林[2] 

机构地区：[1]浙江省永康市第一人民医院外一科,321300 [2]上海交通大学附属第一人民医院普外科

出　　处：《中华普通外科杂志》2016年第7期541-544,共4页Chinese Journal of General Surgery

摘　　要：目的探讨供受体补体c7基因多态性rs3792642和肝细胞癌肝移植术后复发及生存的关联。方法收集2007年7月至2012年8月于上海市第一人民医院行原位肝移植术61例肝细胞癌肝移植患者标本检测供受体C7rs3792642位点的单核苷酸多态性，结合患者临床资料．分析不同基因型与肝移植术后复发及生存的相关性。结果受体C7rs3792642基因多态性和肝移植术后复发显著相关，供体未发现明显相关。在多元回归分析中：微血管浸润（P=0．015）、受体C7rs3792642基因型（CC比crr／TTP=0．032），以及超出米兰标准（P=0．013）为肝癌复发的独立危险因素。受体C7rs3792642cT／TT型无瘤生存时间和总生存时间显著高于cc型（P=0．008和P=0．011）。Cox风险模型中，TNM分期、受体C7rs3792642基因型和微血管浸润为独立影响预后的因素（P〈0．05）。结论受体C7rs3792642基因型与肝细胞癌行肝移植术后复发及生存显著相关，对肝癌肝移植预后有潜在的临床预测价值。Objective To investigate the association between donor and recipient C7 gene polymorphisms and risk of hepatocellular carcinoma （HCC） recurrence and prognosis following orthotopic liver transplantation （ OLT）. Methods A total of 76 HCC patients undergoing OLT in Shanghai First People＇s Hospital from July 2007 to August 2012 were included in this study. A single nucleotide polymorphism （SNP）, C7 rs3792642 was genotyped and analyzed together with clinical data in donors and recipients. Results Recipient rs3792642 polymorphism was sigmfieantly associated with HCC recurrence following OLT. In multivariate logistic regression analysis, micro-vascular invasion （ P = 0. 015 ） , recipient C7 rs3792642 genotype （ CC vs. CT/TT P = 0. 032 ） and out of Milan criteria （ P = 0. 013 ） were identified as independent risk factors of HCC recurrence. Recurrence-free survival （RFS） and overall survival （OS） were significantly higher in the recipient CT/TT group than in the CC group （ P = 0. 008 and P = 0. 011, respectively）. Cox proportional hazards modeling revealed that TNM stage, recipient C7 rs3792642 genotype, and micro-vascular invasion were independent factors （P 〈 0. 05 ） for patients clinical outcomes. Conclusion Recipient C7 rs3792642 polymorphism is associated with the risk of HCC recurrence following OLT and has a potential clinical value predicting the proznosis of HCC patients treated with OLT.

关 键 词：肝移植 多态性 单核苷酸 癌 肝细胞 复发 

分 类 号：R735.7[医药卫生—肿瘤]