可切除肝细胞癌患者癌旁肝组织中分泌型簇集蛋白的表达与术后生存预后的相关性  

Correlation between expression of secretory clusterin and postoperative survival prognosis in paracancerous liver tissues of patients with resectable hepatocellular carcinoma

作　　者：黄蓉 樊斌 丁俊 HUANG Rong;FAN Bin;DING Jun(Department of Hepatobiliary,Pancreatic and Splenic Surgery,the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture in Hubei Province,Enshi,Hubei,445000)

机构地区：[1]湖北省恩施土家族苗族自治州中心医院肝胆胰脾外科,湖北恩施445000

出　　处：《实用临床医药杂志》2022年第8期37-43,共7页Journal of Clinical Medicine in Practice

基　　金：湖北省恩施土家族苗族自治州科技计划项目(E20170006)。

摘　　要：目的探讨可切除肝细胞癌(HCC)患者癌旁肝组织中分泌型簇集蛋白(sCLU)的表达与术后生存预后的相关性。方法收集208例接受肝切除术的HCC患者的血清、切除的肿瘤组织和癌旁肝组织。采用酶联免疫吸附法测定血清sCLU水平;采用免疫组化法检测肿瘤组织和癌旁肝组织中sCLU的表达。结果所有患者中位随访时间为58.0个月,患者术前血清sCLU水平为89.11(63.23,119.47)μg/mL。血清sCLU水平与肿瘤分期无相关性。高水平(≥89.11μg/mL)与低水平(<89.11μg/mL)血清sCLU患者的无病生存率比较,差异无统计学意义(P>0.05)。115例(55.29%)肿瘤组织和81例(38.94%)癌旁肝组织中sCLU蛋白呈阳性表达。肿瘤组织中sCLU蛋白阳性表达与阴性表达患者的无病生存率比较,差异无统计学意义(Log-rankχ^(2)=1.763,P=0.184)。癌旁肝组织中sCLU蛋白阳性表达患者的术后无病生存率较阴性表达者更低,差异有统计学意义(Log-rankχ^(2)=9.853,P=0.002)。多因素Cox比例风险模型分析显示,癌旁肝组织sCLU蛋白阳性表达是HCC患者术后无病生存和总生存的独立危险因素(P<0.05)。结论在可切除HCC患者中,癌旁肝组织sCLU蛋白阳性表达预示着患者术后无病生存和总生存不良,sCLU可作为HCC切除术后预防肿瘤复发的有效靶点。Objective To explore the correlation between expression of secretory clusterin(sCLU)and postoperative survival prognosis in paracancerous liver tissues of patients with resectable hepatocellular carcinoma(HCC).Methods Serum samples,resected tumor tissues and paracancerous liver tissues were collected from 208 HCC patients with hepatic resection.Serum sCLU level was detected by enzyme-linked immunosorbent assay;sCLU expressions in resected tissues and paracancerous liver tissues were detected by immunohistochemistry.Results The median follow-up time was 58.0 months in all the patients,and the preoperative serum sCLU level was 89.11(63.23,119.47)μg/mL.There was no correlation between serum sCLU level and tumor staging.There was no significant difference in disease-free survival rate between patients with high level sCLU(≥89.11μg/mL)and low level sCLU(<89.11μg/mL)(P>0.05).The expression of sCLU protein was positive in 115 tumor tissues(55.29%)and 81 paracancerous liver tissues(38.94%).There was no significant difference in disease-free survival rate between patients with positive and negative expression of sCLU protein in tumor tissues(Log-rankχ^(2)=1.763,P=0.184).The postoperative disease-free survival rate was significantly lower in patients with positive expression of sCLU protein in paracancerous liver tissue(Log-rankχ^(2)=9.853,P=0.002).Multivariate Cox proportional hazards model analysis showed that the positive expression of sCLU protein in paracancerous liver tissue was an independent risk factor for disease-free survival and overallsurvival of HCC patients(P<0.05).Conclusion In patients with resectable HCC,the positive expression of sCLU protein in paracancerous liver tissue indicates that the disease-free survival and overall survival are poor,and sCLU can be used as an effective target to prevent tumor recurrence after HCC resection.

关 键 词：分泌型簇集蛋白 肝细胞癌 癌旁肝组织 无病生存率 预后 

分 类 号：R735.7[医药卫生—肿瘤] R730.23[医药卫生—临床医学]