肝癌中脱-γ-羧基凝血酶原的表达及意义

Des-gamma-carboxy-prothrombin expression in hepatocellular carcinoma and its clinical significance

目的:探讨肝癌组织中脱-γ-羧基凝血酶原的表达情况及临床意义. 方法:用免疫组化法探讨了92例肝癌及癌旁组织,7例转移性肝癌和19例慢性肝病组织中脱-γ-羧基凝血酶原的表达水平,并分析脱-γ-羧基凝血酶原与肝癌的临床病理特征间的关系. 结果:肝癌组织脱-γ-羧基凝血酶原阳性率(73.9%)明显高于癌旁组织(26.1%,P<0.01),但二者脱-γ-羧基凝血酶原阳性率明显高于转移性肝癌和慢性肝病肝组织(3.5%, P<0.01).浸润性生长的肝癌组织脱-γ-羧基凝血酶原阳性率明显高于膨胀性生长的肝癌组织(P=0.049),无包膜形成的肝癌组织明显高于有包膜形成的肝癌组织(P=0.037).最大径>5 cm组的癌旁组织的脱-γ-羧基凝血酶原阳性率明显高于直径≤5 cm组癌旁组织(P=0.049),HBsAg和HCVAb均阴性或单HBsAg阳性的患者癌旁组织脱-γ- 羧基凝血酶原染色阳性率明显高于HCVAb阳性组患者(P<0.01).肝硬化的癌旁组织脱-γ-羧基凝血酶原阳性率明显低于慢性肝炎的癌旁组织(P<0.01).肝癌组织、癌旁组织脱-γ-羧基凝血酶原阳性率与肝癌其他临床病理特征无明显的关系(P>0.05). 结论:脱-γ-羧基凝血酶原可能是预测肝癌发生的重要标志物,但不能作为肝癌的预后指标.

AIM: To study the expression of des-gamma-carboxy-pro-thrombin (DCP) in hepatocellular carcinoma (HCC) tissues and its clinical significance. METHODS: Cancerous and non-cancerous tissue samples prepared from 92 cases of HCCs, 7 metastatic HCCs and 19 chronic liver diseases were subjected to immunohis-tochemical staining for tissue DCP. Relation between DCP expression in cancerous and non-cancerous tissues and clinical parameters of HCC was analyzed. RESULTS: The DCP expression in cancerous tissues (73.9%) was significantly higher than that in non-cancerous tissues (26.1%, P<0.01). The DCP expression in cancerous and non-cancerous tissues of HCC was significantly higher than that in non-cancerous tissues of metastatic HCCs and chronic liver diseases (3.5%, P<0.01). Positive DCP staining in cancerous tissues was more frequently in cases of infiltrative growth than in cases of expansive growth (P =0.049), and was more frequently in cases where no capsule formation was noted than that in cases with capsule formation (P =0.037). The DCP expression in non-cancerous tissues of HCC with size >5 cm was significantly higher than that of the size s≤5 cm (P =0.049). Positive DCP staining in non-cancerous tissue was more frequently in cases of tumors larger than 5 cm than in cases of tumors that were 5 cm or smaller (P =0.049). DCP expression in non-cancerous tissues of patients who were either negative for both hepatitis markers or positive for the HBsAg was significantly higher than the patients who were positive for the HCVAb (P<0.01). The rate of positive DCP staining in non-cancerous tissues was also significantly lower in patients with liver cirrhosis than that in patients with chronic hepatitis (P <0.05). No correlations were found between DCP expression in cancerous and non-cancerous tissues and other clinical parameters. CONCLUSION: DCP may be an important marker in liver carcinogenesis, but DCP in tissues cannot be considered as a prognostic factor for HCC.