大鼠ALPPS一期术后Lgr5蛋白表达变化及其与肝脏再生的关系  

Study on relationship between remnant liver regeneration after ALPPS and Lgr5 protein expression in rat

作　　者：刘伟伟 方征 夏咸军 柏杨 谢伟选 濮毅峰 罗昆仑 LIU Weiwei;FANG Zheng;XIA Xianjun;BAI Yang;XIE Weixuan;PU Yifeng;LUO Kunlun(Department of Hepatobiliary Surgery,The 904th Hospital of Joint Logistic Support Force of PLA,Wuxi,Jiangsu 214044,P.R.China)

机构地区：[1]中国人民解放军联勤保障部队第九〇四医院肝胆外科,江苏无锡214044

出　　处：《中国普外基础与临床杂志》2021年第10期1275-1279,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：南京军区医药卫生科研基金(项目编号:14D05)。

摘　　要：目的探讨G蛋白偶联受体家族一员Lgr5在联合肝脏离断和门静脉结扎分期肝切除(ALPPS)一期术后残肝再生组织中的表达变化及其意义。方法将120只SD雄性大鼠(200~240 g)采用随机数字表法均分为假手术(SO)组、门静脉结扎(PVL)组和ALPPS组;分别在术后第1、2、4、7天时观察肝再生及检测肝功能(ALT、AST)情况,同时观察肝组织病理学改变及肝右中叶组织中Ki-67和Lgr5蛋白表达变化。结果肝脏再生率、Ki-67蛋白表达阳性率和Lgr5蛋白相对表达量在PVL组和ALPPS组术后第1、2、4天时均高于SO组(P<0.05)且2组的肝脏再生率在第7天时仍高于SO组(P<0.05);肝脏再生率在ALPPS组术后第4、7天时高于PVL组(P<0.05)、Ki-67蛋白表达阳性率和Lgr5蛋白相对表达量在第2、4天时高于PVL组(P<0.05)。ALT和AST水平在PVL组和ALPPS组术后第1、2天时均高于SO组(P<0.05),其在ALPPS组仅在术后第1天时高于PVL组(P<0.05),在第4天即可恢复正常。结论ALPPS可更好地促进肝再生,Lgr5与ALPPS术后肝再生密切相关,ALPPS术后肝干细胞可能参与了肝再生。Objective To investigate the expression of Lgr5 protein in regeneration tissue of remnant liver after associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)and its significance.Methods A total of 120 male SD rats(200–240 g)were randomly equally divided into sham operation(SO)group,portal vein ligation(PVL)group,and ALPPS group using random number table method.The liver regeneration rate(LRR),liver function(AST and ALT),and the expressions of Ki-67 and Lgr5 in the right middle lobe of the liver were observed at day 1,2,4,and 7 after surgery.Results Compared with SO group,the LRRs and the Ki-67 protein expression positive rates and Lgr5 related protein expression levels in the right middle lobe of liver tissue were increased in the PVL group and ALPPS group at day 1,2,and 4 after surgery(P<0.05),and the LRR was still increased at day 7 after surgery(P<0.05).The LRRs at day 4 and 7 after surgery in the ALPPS group were higher than those in the PVL group(P<0.05),the Ki-67 protein expression positive rates and Lgr5 related protein expression levels at day 2 and 4 after surgery in the ALPPS group were higher than those in the PVL group(P<0.05).The AST and ALT levels at day 1 and 2 after surgery in the ALPPS group and PVL group were higher than those in the SO group(P<0.05),which at day 1 after surgery in the ALPPS group were higher than those in the PVL group(P<0.05),but which returned to normal on day 4 after surgery.Conclusions ALPPS could promote liver regeneration better.Lgr5 is closely related to liver regeneration after ALPPS.Liver stem cells might be involved in liver regeneration after ALPPS.

关 键 词：LGR5 联合肝脏离断和门静脉结扎分期肝切除术 肝脏再生 大鼠 

分 类 号：R657.3[医药卫生—外科学]