肝细胞癌临床病理特征与hTERT表达的关系

The Relationship between Telomerase Reverse Transcriptase Expression and Clinicopathological Features of Hepatocellular Carcinoma

目的探讨hTERT表达在肝癌发生、发展进程中作用以及可能的临床诊断价值。方法采用RT-PCR检测hTERT在32例肝细胞癌组织和相应癌旁组织的表达情况,比较分析hTERT表达与肝细胞癌临床病理的关系。结果(1)32例肝癌中,hTERT表达阳性的有27例(84.38.%);表达阴性的有5例(15.62%),癌旁组织中仅有3例表达阳性(9.38%),二者比较有统计学意义(P<0.05)。(2)hTERT表达与年龄、HBsAg、肝硬化、肿瘤包膜是否完整、肿瘤位置、癌栓形成、肿瘤组织分化程度以及临床分期等临床病理特征无关(P>0.05);相关分析表明hTERT表达与肿瘤大小成正相关(r=0.497,P=0.004)。hTERT表达阳性肿瘤多大于5 cm。结论(1)hTERT表达存在明显组织特异性,可以作为HCC诊断的一个特异性指标。(2)hTERT表达阳性肿瘤多为>5 cm的肿瘤,可能预示着hTERT表达肿瘤侵袭性较强,预后较差,是评估肝细胞癌手术疗效的有效指标之一。

Objective To assess the importance of hTERT expression in the ocurrence and progression of HCC and its potential clinic diagnosis. Methods Reverse Transcriptase Polymerase chain reaction（RT-PCT） was used to detect hTERT mRNA expression in HCC and neighboring tumor-free tissues in 32 cases of HCC. The relations between positive or negative expression of hTERT mRNA and clinicopathological index were investigated. Results （1） The positive hTERT expression was observed in 27 out of 32（84.38%） cases of HCC,While the negative was 5 out of 32 cases （15.62%） and there was only 3 positive cases in adjacent non-cancerous liver tissues,in which a significant lower brightness was detected as compared with corresponded cancerous tissues（P〈0.05）. （2）There was no significant relation between the hTERT expression of HCC tissues and clinicopathological features such as age, HBsAg, liver cirrhosis, tumor encapsulation, tumor location, tumor thrombus, degree of histologic differentiation, and clinic stage （P〉0.05） ; correlation analysis reveals positive correlation between positive hTERT expression and tumor size（r=0. 497 ,P=0. 004）. The diameter of the hTERT positive tumor was over 5 cm. Conclusion （1） The hTERT expression which exists in the significant tumor tissue specificity. The detection of hTERT expression could act as a specific marker in diagnosis of HCC in future. （2）The tumor size of the tumor with positive hTERT expression is often-fold bigger than 5 cm,which indicates that such tumors has stronger invasive and worse prognosis. The detection of hTERT expression would be a good guide line for evaluating curative effect of hepatectomy for HCC.