FOXC2对肝癌肝移植患者预后的影响  

Effect of FOXC2 on prognosis of liver transplant patients with primary liver cancer

作　　者：江哲龙 魏志鸿 杜俊杰 江艺 吕立志 杨芳 Jiang Zhelong;Wei Zhihong;Du Junjie;Jiang Yi;Lyu Lizhi;Yang Fang(Department of Hepatobiliary Surgery,the 900th Hospital of PLA Joint Logistics Support Force,Fuzhou 350025,China)

机构地区：[1]解放军联勤保障部队第九OO医院肝胆外科,福州350025

出　　处：《中华肝脏外科手术学电子杂志》2022年第3期309-314,共6页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：福建省社会发展引导性(重点)项目(2019Y0068);福建省自然科学基金面上项目(2019J01533)。

摘　　要：目的探讨转录因子叉头框C2(FOXC2)对原发性肝癌(肝癌)肝移植患者预后的影响。方法回顾性分析2008年1月至2014年1月在解放军联勤保障部队第九OO医院行原位肝移植的226例患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男159例,女67例;年龄38~73岁,中位年龄54岁。采用RT-PCR和Western blot检测肝癌组织和癌旁组织中FOXC2 mRNA和蛋白表达水平,分析FOXC2表达与患者临床病理特征的关系,判断FOXC2在术后肿瘤复发和预后中的价值。FOXC2 mRNA相对表达量与患者临床病理特征的关系采用单因素方差分析或t检验分析。生存分析采用Kaplan-Meier法和Log-rank检验。预后影响因素分析采用Cox比例风险回归模型。结果肝癌组织FOXC2 mRNA相对表达量为5.29±1.21,明显高于癌旁组织的3.70±0.79(t=17.183,P<0.05)。肝癌组织FOXC2 mRNA相对表达量与肝癌肝移植患者HBsAg、术前AFP、肿瘤最大直径、卫星灶、肿瘤分化、肿瘤包膜、微血管侵犯相关(t=-4.341,-5.028,-4.461,-2.619,3.919,2.261,-2.107;P<0.05)。FOXC2高表达组和低表达组术后3年复发率分别为35.93%和12.24%,5年生存率分别为58.59%和86.73%,差异有统计学意义(χ^(2)=23.849,17.975;P<0.05)。Cox多因素分析显示,FOXC2 mRNA水平为肝癌肝移植患者术后肿瘤复发和总体生存的独立影响因素(HR=0.197,0.221;P<0.05)。结论FOXC2在肝癌中高表达。FOXC2高表达患者肝移植术后复发率高,预后较差。Objective To evaluate the effect of forkhead transcription factor C2(FOXC2)on the clinical prognosis of patients with primary liver cancer(PLC)after liver transplantation.Methods Clinical data of 226 patients undergoing orthotopic liver transplantation in the 900th Hospital of PLA Joint Logistics Support Force from January 2008 to January 2014 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,159 patients were male and 67 female,aged from 38 to 73 years,with a median age of 54 years.The expression levels of FOXC2 mRNA and protein in the liver cancer tissues and adjacent tissues were determined by RT-PCR and Western blot.The relationship between FOXC2 expression and clinicopathological features of patients was analyzed.The value of FOXC2 in postoperative tumor recurrence and prognosis was evaluated.The relationship between the relative expression of FOXC2 mRNA and clinicopathological features of patients was analyzed by one-way ANOVA or t test.Survival analysis was performed by Kaplan-Meier method and Log-rank test.Prognostic factors were identified by Cox proportional hazards regression model.Results The relative expression level of FOXC2 mRNA in liver cancer tissues was 5.29±1.21,significantly higher than 3.70±0.79 in adjacent tissues(t=17.183,P<0.05).The relative expression of FOXC2 mRNA in liver cancer tissues was significantly correlated with HBsAg,preoperative AFP,maximum tumor diameter,tumor budding,tumor differentiation,tumor encapsulation and microvascular invasion(t=-4.341,-5.028,-4.461,-2.619,3.919,2.261,-2.107;P<0.05).In the high and low FOXC2 expression groups,the postoperative 3-year recurrence rates were 35.93%and 12.24%,and the postoperative 5-year survival rates were 58.59%and 86.73%,where significant differences were observed(χ^(2)=23.849,17.975;P<0.05).Cox multivariate analysis showed that expression level of FOXC2 mRNA was an independent influencing factor of tumor recurrence and overall survival

关 键 词：癌 肝细胞 肝移植 叉头框C2 微血管侵犯 预后 

分 类 号：R73[医药卫生—肿瘤]