Gelsolin在肝细胞肝癌中的表达及与预后的关系  

Expression of Gelsolin in patients with hepatocellular carcinoma and its correlation with prognosis

作　　者：邓雯[1] 张轶西 冯佩[1] 苏鸿君[1] 杨洁文[1] 吴燕峰[1] DENG Wen;ZHANG Yi-xi;FENG Pei;SU Hong-jun;YANG Jie-wen;WU Yan-feng(Biotherapy Department,Sun Yat-sen Memorial Hospital,Guangzhou Guangdong 510120,China;Organ Transplant Center,First Affiliated Hospital of Sun Yat-sen University,Guangzhou Guangdong 510080,China)

机构地区：[1]中山大学孙逸仙纪念医院生物治疗中心,广东广州510120 [2]中山大学附属第一医院器官移植科,广东广州510080

出　　处：《局解手术学杂志》2018年第11期778-783,共6页Journal of Regional Anatomy and Operative Surgery

基　　金：国家自然科学基金(81373156)

摘　　要：目的研究Gelsolin(GSN)在肝细胞肝癌(HCC)患者中的表达情况及其与肝癌切除术后复发及预后的关系。方法回顾性分析2006年1月1日至2008年12月31日在中山大学附属第一医院行肝癌切除术的188例HCC患者的临床病理及生存资料。收集患者的肝癌组织和对应的癌旁组织病理学标本,并切片进行石蜡包埋,应用免疫组织化学染色测定GSN的表达水平。观察肝癌组织及癌旁组织中GSN蛋白表达情况;肝癌组织中GSN蛋白的表达与患者临床病理因素之间的关系;患者生存情况;并对肝癌患者的临床预后因素进行分析。采用电话及门诊方式进行随访,了解患者的生存情况;随访时间截至2015年10月31日。偏态分布的计量资料运用范围表示。计数资料运用双侧χ2或配对χ2检验。采用Kaplan-Meier法绘制生存曲线并计算生存率,Log-rank检验进行生存分析。运用COX比例风险模型进行单因素及多因素分析。结果免疫组织化学染色结果表明GSN蛋白在肝癌组织中主要表达于细胞质,呈强棕黄色染色。188例患者GSN蛋白在肝癌组织中的表达情况,95例呈高表达,93例呈低表达。188例患者术后均获得随访,随访时间为82～118个月,平均随访时间为96个月。188例患者随访期间,54例肿瘤无复发,134例肿瘤复发; 83例生存,105例死亡;术后3、5年总体生存率分别为50. 53%、42. 02%,无瘤生存率分别为31. 91%、28. 72%。单因素分析结果显示:术前AFP、肿瘤数量、肿瘤最大径、包膜浸润、脉管内癌栓、肿瘤Edmondson病理学分级及GSN蛋白表达水平均是影响肝癌患者5年总生存率(风险比OR=2. 06、0. 79、3. 16、2. 37、2. 87、3. 21、1. 62; 95%可信区间1. 34～5. 26、0. 07～0. 82、1. 79～7. 31、1. 49～4. 96、1. 21～8. 93、1. 19～7. 92、1. 11～2. 37,P <0. 05)及无瘤生存率(风险比OR=2. 17、0. 78、3. 66、2. 43、2. 23、3. 36、1. 74; 95%可信区间:1. 17～4. 23、0. 08～0. 79、2. 10～6. 42Objective To investigate the expression of Gelsolin（GSN） in patients with hepatocellular carcinoma（HCC）,and to explore the correlation of GSN expression level with prognosis and HCC recurrence. Methods The clinicopathological data of 188 patients who underwent liver resection for HCC in the first hospital of SYSU from January 1,2006 to December 31,2008 were retrospectively analyzed. The specimens of HCC tissues and adjacent mucosa were collected and embedded in paraffin. The expression level of GSN were detected by immunohistochemistry staining. The expression of GSN in HCC tissues and adjacent mucosa,the correlation between expression level of HCC tissues and clinicopathologic characteristics,and survival situation were observed to analyse the prognostic factors after liver resection. The survival situation of patients were followed up by telephone interview and outpatient interview. The followed-up time was up to October 31,2015.Measurement data with skewed distribution were represented as range. The comparison between groups of count data was done by using the chi-square test. The survival curve was drawn by the Kaplan-Meier method,and the survival analysis was performed by Log-rank test. The univariate and multivariate analysis were respectively done by using the COX regression model. Results Immunohistochemistry staining showed that GSN was mainly expressed in the cytoplasm,with a powerful brownish-yellow staining. The high expression and low expression of GSN in HCC tissues were detected in 95 and 93 patients,respectively. All of 188 patients were followed up for ranged from 82 to 118 months,with an average time of 96 months. During the follow-up,54 patients had no tumor recurrence and other 134 patients had tumor recurrence; 83 survived and 105 died; the 3-and 5-year overall survival rates were respectively 50. 53% and 42. 02%,and 3-and 5-year tumor-free survival rates were respectively 31. 91% and 28. 72%. The results of univariate analysis showed that preoperative alpha-fetoprotein（AFP）,tumor

关 键 词：肝细胞肝癌 GELSOLIN 凋亡 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]