细胞角蛋白19/磷脂酰肌醇蛋白聚糖3表达模式与肝细胞癌患者介入治疗后复发的相关性  

Correlation between the expression profile of cytokeratin 19/glypican 3 and recurrence of hepatocellular carcinoma after interventional therapy

作　　者：郑秀 袁春旺[2] 崔雄伟[2] 吕福东[1] 赵大伟[3] 刘红刚[4] 冯骥良[1] Zheng Xiu;Yuan Chunwang;Cui Xiongwei;Lyu Fudong;Zhao Dawei;Liu Honggang;Feng Jiliang(Pathology Department of Beijing You’an Hospital,Capital Medical University,Beijing 100069,China;Interventional Radiology Department of Beijing You’an Hospital,Capital Medical University,Beijing 100069,China;Radiodiagnosis Center of Beijing You’an Hospital,Capital Medical University,Beijing 100069,China;Pathology Department of Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京佑安医院病理科,100069 [2]首都医科大学附属北京佑安医院介入治疗科,100069 [3]首都医科大学附属北京佑安医院医学影像科,100069 [4]首都医科大学附属北京同仁医院病理科,100730

出　　处：《中华肝脏病杂志》2020年第11期936-941,共6页Chinese Journal of Hepatology

基　　金：首都医科大学附属北京佑安医院院内中青年人才孵育项目(YNKTTS20180110)。

摘　　要：目的观察细胞角蛋白19/磷脂酰肌醇蛋白聚糖3(CK19/GPC3)的表达模式与肝细胞癌患者介入治疗术后复发的相关性。方法回顾性收集了佑安医院2007年11月至2016年5月接受介入治疗的符合条件的251例肝细胞癌患者的临床及病理资料,并对可能影响其预后的相关风险因素进行了单因素和多因素COX回归分析。Kaplan-Meier生存分析法绘制患者生存曲线,Log-rank检验比较各组间生存率的差异。结果Kplan-Meier单因素分析显示组织学分级、CK19/GPC3表达模式、甲胎蛋白水平及Hep Par1与肿瘤复发密切相关,多因素COX回归分析显示CK19/GPC3表达模式(HR=1.634,95%CI为1.041~2.564,P=0.033)、组织学分级(HR=1.445,95%CI为1.037~2.014,P=0.030)、甲胎蛋白水平(HR=1.410,95%CI为1.042~1.908,P=0.026)、Hep Par1(HR=0.570,95%CI为0.349~0.930,P=0.025)4个因素为介入治疗后复发的独立预测因子。结论符合米兰标准的具有CK19^+/GPC3^+与CK19^-/GPC3^+表型的肝细胞癌患者介入治疗后较CK19-/GPC3-的患者具有更高的复发风险。Objective To observe the correlation between the expressions profile of cytokeratin 19/glypican 3(CK19/GPC3)and recurrence of hepatocellular carcinoma after interventional therapy.Methods Clinical and pathological information of 251 eligible cases with hepatocellular carcinoma who underwent interventional therapy in You'an Hospital from November 2007 to May 2016 were retrospectively collected.Univariate and multivariate Cox regression analysis was used to analyze the relevant risk factors that may affect their prognosis.Kaplan-Meier survival analysis was used to draw the survival curve.Log-rank test was used to compare the difference in survival rates between the groups.Results Kaplan-Meier univariate analysis showed that histological grade,CK19/GPC3 expression profile,alpha-fetoprotein level and Hep Parl were closely related to tumor recurrence.Multivariate Cox regression analysis showed CK19/GPC3 expression profile(HR=1.634,95%CI:1.041~2.564,P=0.033),histological grade(HR=1.445,95%CI:1.037~2.014,P=0.030),alpha-fetoprotein level(HR=1.410,95%CI:1.042~1.908,P=0.026),Hep Parl(HR=0.570,95%CI:0.349~0.930,P=0.025)were the four independent factors for prediction of recurrence after interventional therapy.Conclusion Hepatocellular carcinoma patients with CK19+/GPC3+and CK19-/GPC3+phenotypes who meet the Milan criteria have a higher risk of recurrence after interventional therapy than CK19-/GPC3-phenotypes.

关 键 词：肝细胞癌 肝硬化 介入治疗 细胞角蛋白19 磷脂酰肌醇蛋白聚糖3 米兰标准 

分 类 号：R735.7[医药卫生—肿瘤]