HBx在乙肝相关性肝细胞癌中表达的意义及其对预后的影响  

Expression and significance of HBx protein in HBV-related hepatocellular carcinoma and its impacts on prognosis

作　　者：余咸辉 鄢业鸿[2] 董春华[3] 李剑锋[2] 肖建生[2] 李包根 王建祥[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院普外科,武汉430000 [2]南昌大学第一附属医院肝胆外科 [3]江西省儿童医院检验科 [4]宜春市人民医院普外科

出　　处：《中华普通外科杂志》2017年第11期952-955,共4页Chinese Journal of General Surgery

基　　金：江西省科技厅支撑计划基金资助项目（20132BBG70050）

摘　　要：目的探讨HBx蛋白在乙肝相关性肝细胞癌及癌旁组织中的表达，与相关临床因素间的关系。方法通过Elivision二步法，检测40例根治性切除肝细胞癌（hepatocellular carcinoma,HCC）和癌旁组织中HBx表达，分析其与眭别、年龄、TNM分期、HBV—DNA负荷、AFP、肝硬化、脉管侵犯、肿瘤淋巴细胞浸润（tumor lymphocyte infiltration, TIL）、Edmondson—Steiner病理分级及无瘤生存时间（tumor free survival time，DFS）的关系。结果（1）肝癌组织和癌旁组织HBx表达比较，差异有统计意义（χ^2=10．026，P=0．002）。（2）癌旁中HBx在HBV—DNA〈500IU／ml和≥500IU／ml比较，差异有统计学意义（χ^2=6．536，P=0．011）；与年龄、性别、肝硬化及血清AFP相关不显著。（3）癌组织脉管侵犯和无侵犯的HBx表达比较，差异有统计意义（χ^2=5．079，P=0．037）；与TNM分期、Edmondson．Steiner病理分级关系不显著。（4）癌旁组织中有TIL和少TIL的HBx表达比较，差异有统计意义（χ^2=8．711，P=0．003），与DFS无明显相关；在癌组织DFS〈24个月和≥24个月组差异有统计意义（χ^2=6．857，P=0．009），与TIL无明显相关。结论HBx在癌旁组织高表达，癌组织低表达，癌组织中高HBx表达可能预示预后较差，癌旁组织高表达可能预示预后较好。Objective To explore the relationship between the expression of HBx protein in HBV- related HCC samples and the clinical implications. Methods Elivision two-step was used in this study to detect the expression level of HBx protein in 40 HCC tissues, corresponding para-tumorous tissues from patients with HBV-related HCC undergoing curative hepatectomy. The relationship between HBx protein and clinical parameters （such as gender, age, TNM stage, HBV-DNA load, AFP, liver cirrhosis, a merger of vascular invasion, tumor infiltrating lymphocytes, Edmondson-Steiner histopathological grading, with or without relapse within 24 months） were analyzed. Results （ 1 ） The expression of HBx protein in the tumorous tissues was significantly lower than that of para-tumorous tissues （ P 〈 0. 05）. （2） In the tissues of para-tumorous, the expression of HBx protein in group HBV-DNA 〈 500 IU/ml was significantly lower than that of group HBV-DNA 1〉 500 IU/ml （P 〈 0. 05）. There were no significant differences in the expression of HBx protein irrespective of gender, age, cirrhosis and the AFP level. （3）In the tissues of tumorous, the expression of HBx protein in group with vascular invasion was significantly higher than that of group without vascular invasion （P 〈 0. 05 ）. However, there were no significant differences in the expression of HBx protein among the factors of TNM stage and Edmondson-Steiner histopathology grading. （4） In para-tumorous tissues, the expression of HBx protein in group of lymphocytic infiltration was significantly higher than that without lymphocytic infiltration （ P 〈0. 05 ）. In the tissues of tumorous, the expression of HBx protein in disease-free survival （ DFS ） 〈 24M patients was significantly higher than DFS ≥ 24M （ P 〈 0.05 ）. Conclusions High HBx expression in tumor tissues indicates poor prognosis while that in para-tumorous tissues predicts a better prognosis.

关 键 词：癌 肝细胞 基因表达 HBX蛋白 

分 类 号：R512.62[医药卫生—内科学]