HBV感染与p53及Survivin蛋白表达在原发性肝细胞癌中的关系及临床意义

Hepatitis B virus(HBV)infection and expression of p53 and survivin in hepatocellular carcinoma(HCC)

目的:探讨乙型肝炎病毒(hepatitis B virus,HBV)感染在原发性肝细胞癌(hepatocellular carci-noma,HCC)发生中的病因学意义及其与Survivin及p53蛋白表达的相关性及对HCC生物学行为的影响。方法:利用血清学指标检测61例HCC的HBV感染情况,采用免疫组化检测癌组织中Survivin及p53蛋白的表达。结果:HBV感染组中Survivin及p53蛋白表达率分别为69.23%(27/39)和71.97%(28/39);非HBV感染组中二者的阳性表达率为31.81%(8/22)及40.90%(9/22);分别有显著性差异(P<0.05)。p53及Survivin表达与门脉癌栓形成、肿瘤直径大小及AFP增高相关,与分化程度及肝内转移无关;p53表达与Survivin表达正相关。在HCC中HBV感染与肿瘤的Edmondson分级、AFP增高、门静脉癌栓形成、肝内转移及转氨酶升高相关(P<0.05)。结论:HBV感染可能与p53及Survivin共同作用导致HCC的发生及发展。

Objective： To study the influences of HBV infection on biological behaviour of hepatocellular cancinoma （HCC） and the expression of surviving and p53 protein and their relationship. Methods： The state of HBV infection was determined by serum test in 61 patients with hepatocellular cancinoma. SP immunohistochemical （IHC） method was employed to detect the expression of p53 and survivin protein in the mean time. Results： The positive rate of survivin （69.23%） （27/39）and p53 （71.97%） （28/39） in HBV- positive group was significantly higher（P〈0.05）than that of （40.90%）（9/13） and （31.81%）（8/ 22）in HBV-negative group. The expression of p53 and survivin was positively correlated with carcinomatous embolism of portal vein, tumour size and elevation of serum alpha-fetoprotien （AFP） level, had no correlation with differentiation and intrahepatic metastasis. The expression of survivin significantly related with that of p53. The state of HBV infection was positively correlated with Edmondson grade,elevation of serum alpha-fetoprotion （AFP）level, carcinomatous embolism of portal vein, intrahepatic metastasis, and elevation of serum γ-glutamyl transferase（P〈0.05）. Conclusion; The state of HBV infection interacts on the expression p53 and survivin protein in the occurrence and development of HCC.