P53及MVD与肝细胞性肝癌肝移植术后肿瘤复发的关系

Correlation of P53 and MVD with tumor recurrence after liver transplantation in patients with hepatocellular carcinoma

目的探讨肝细胞性肝癌（HCC）中P53蛋白表达及肿瘤微血管密度（MVD）与HCC肝移植术后肿瘤复发的关系。方法采用免疫组化检测HCC组织中P53蛋白表达，CD34标记癌组织血管内皮细胞，计算MVD，统计分析两者及临床病理因素与肝移植术后肿瘤复发的关系、两者与临床病理因素之间及两者相互之间的关系。结果单因素分析表明P53蛋白表达、MVD、肿瘤TNM分期及肿瘤脉管浸润对HCC肝移植术后肿瘤复发均有影响（P〈0．05），多因素分析后，仅P53和MVD为独立的影响因素；P53蛋白表达和MVD与肿瘤脉管浸润显著正相关（P〈0．05）；P53蛋白表达阳性的肝癌组织MVD显著高于阴性表达者（P=0．01）。结论P53蛋白表达和MVD对预测HCC肝移植术后的肿瘤复发有重要价值；P53蛋白表达阳性和高MVD者易出现肿瘤脉管浸润；P53蛋白表达与肿瘤血管生成密切相关。

Objective To explore the role of P53 and MVD in predicting recurrence of hepato- cellular carcinoma （HCC） following orthotopic liver transplantation （OLT）. Methods Forty patients with HCC who underwent OLT between 2003 and 2004 with a minimum clinical follow up of 18 months were included in this retrospective study. Tissue samples were immunohistochemically stained with P53. Tumor microvessel density （MVD） was evaluated by using CD34. Statistical analysis was performed to identify the relevant factors of tumor recurrence and the relation of P53 and MVD to clin-icopathological features. Results The univariate analysis showed that P53-posltivity （P 0. 025）, MVD （P=0. 001） , pTNM （P=0. 022） and vascular invasion （P 0. 027） were significantly associated with the tumor recurrence of HCC after OLT. The multivariate logistic regression analysis indicated that only P53-positivity and MVD were significant predictors in predicting HCC recurrence. P53 expression and MVD were closely correlated to vascular invasion （P〈0.05）. MVD was significantly higher in P53-positive HCC than that in P53-negative one （P〈0.05）. Conclusion P53 and MVD may be the predictors for the recurrence of HCC after OLT. P53 expression and MVD are closely correlated to vascular invasion. P53 expression is positively associated with MVD.