肿瘤干细胞标志物EpCAM在肝癌肝移植患者中的表达及其与肿瘤复发转移的关系  

Expression of tumor stem cell marker EpCAM in patients undergoing liver transplantation forhepatocellular carcinoma and its relationship with tumor recurrence and metastasis

作　　者：禹琛 毛雨鸽 程倩 倪彦彬[1] 高鹏骥[1] 高杰[1] 朱继业[1] 李照[1] 

机构地区：[1]北京大学人民医院肝胆外科北京市肝癌肝硬化基础研究重点实验室北京大学肝癌诊疗研究中心北京大学器官移植研究所,100044

出　　处：《中华普通外科杂志》2018年第1期61-64,共4页Chinese Journal of General Surgery

基　　金：国家自然科学青年基金资助项目（81502509）

摘　　要：目的研究上皮细胞黏附分子（epithelialcelladhesionmolecule，EpCAM）在肝癌（hepatocellularearcinoma，HCC）肝移植患者中的表达情况及其与预后及术后肝癌复发的关系。方法回顾性分析2000至2010年在北京大学人民医院行肝移植术的83例HCC患者的临床病理及生存资料．应用免疫组织化学染色测定EpCAM的表达水平，并分析其与预后及肿瘤复发的关系。结果单因素分析显示：EpCAM高表达的HCC患者与EpCAM低表达的HCC患者相比，5年总生存率（41．2％比73．3％x2=4．935，P=0．026）和5年无病生存率（41．2％比73．3％x2=4．634，P=0．031）均更低。多因素分析显示：EpCAM高表达的HCC患者肝移植后的复发（HR=2．860，95％CI：1．012～8．083）和死亡风险（HR=2．909，95％CI：1．030～8．217）高于EpCAM低表达患者，EpCAM表达量是HCC患者肝移植术后5年总生存率及5年无病生存率的独立影响因子（P=0．044）。此外，EpCAM表达量与肿瘤远处复发存在明显相关性（P=0．01）。结论EpCAM与肝癌肝移植术后肝癌复发相关．可作为肝癌肝移植患者肿瘤复发和远处转移的预测指标。Objective To investigate the expression of EpCAM （ epithelial cell adhesion molecule） in patients undergoing liver transplantation for hepatocellular carcinoma （HCC）, and to explore the relationship between EpCAM expression level and HCC recurrence. Methods 83 HCC tissue samples were collected and analyzed retrospectively. EpCAM was detected by immunohistochemistry staining and the correlation between EpCAM and clinicopathological features, prognosis and recurrence were analyzed retrospectively from patients undergoing liver trar^splantation in Peking University People＇s Hospital from 2000 to 2010. Results Log-rank univariate survival analysis showed that the 5-year overall survival （41.2% vs. 73.3% , A2 = 4. 935, P = 0. 026 ） and 5-year disease free survival （41.2% vs. 73.3% ,X2 = 4. 634, P = 0. 031 ） of HCC patients with high EpCAM expression level was significantly lower than that with low expression level of EpCAM. COX multivariate survival analysis showed patients with high EpCAM expression had a higher risk of recurrence（HR =2. 860,95% CI：I. 012 -8. 083） and death （HR =2. 909, 95% CI： 1. 030 - 8. 217） after liver transplantation than those with low EpCAM expression, which was an independent predictor of 5-year overall survival and 5-year disease free survival recurrence （ P = 0. 044）. Furthermore, EpCAM expression level was highly related to tumor distant metastasis （ P = 0. 01 ） . Conclusion There was positive relation between high expression of EpCAM and high HCC recurrence after liver transplantation, suggesting that EpCAM can be a predictor for HCC recurrence and long-term survival of patients with HCC after transplantation.

关 键 词：肝移植 细胞黏附分子 存活率分析 复发 

分 类 号：R735.7[医药卫生—肿瘤]