p53、c-Myc在血吸虫感染的原发性肝癌患者肝癌组织中的表达及意义

Expression and significance of p53 and c-Myc in hepatocellular carcinoma with schistosomiasis

目的对有血吸虫感染的肝癌患者肝癌组织p53、c-Myc蛋白的表达及其与肝癌生物学行为进行研究,探讨血吸虫感染与肝细胞癌的关系。方法58例原发性肝细胞癌患者分为两组:原发性肝细胞癌伴有血吸虫病组(HCS组)23例和原发性肝细胞癌不伴有血吸虫病组(HC组)35例。采用免疫组织化学SP法检测所有患者的p53、c-Myc蛋白表达;同时对p53、c-Myc与肝细胞癌的多种临床病理参数的相关性进行分析。结果p53蛋白阳性表达率在两组中分别为73.9%(17/23)和31.4%(11/35),存在显著性差异(P<0.01);而c-Myc蛋白阳性率在HCS组和HC组中无显著性差异(P>0.05)。p53及c-Myc在肝癌组织中的检出率与肝外转移、术后复发及肿瘤分化程度明显相关(P<0.05或0.01)。结论血吸虫感染对肝癌组织中p53突变蛋白的过量表达有一定的促进作用。p53及c-Myc在肝癌组织中的检出率与代表肿瘤不良生物学特征的指标肝外转移、术后复发及肿瘤分化程度明显相关。联合检测p53、c-Myc在肝细胞癌中的表达,可作为估价肝细胞癌生物学行为的参考指标。

Objective To investigate the relationship between p53 and c-myc gene expression and the clinicopathological factors of hepatocellular carcinoma and the effect of schistosomiasis on p53, c-myc gene expression. Methods Fifty-eight patients of hepatocellular carcinoma were selected and divided into two groups： HCS group （hepatocellular carcinoma with schistosomiasis, n = 23） and HC group （hepatocellular carcinoma without schistosomiasis, n = 35）. Immunohistochemistry method was used to detect the p53 and c-Myc proteins expression of all the 58 patients. Results The positive rates of p53 protein expression in HCS group and HC group were 73.9% （17/23） and 31.4% （11/35） respectively, and there were significant differences between two groups （P 〈 0.01 ）. The positive rates of p53 and c-Myc in the HCC tissue were significantly correlated with the presence of extrahepatic metastasis, the recurrence of tumor and the differentiation of tumor （P 〈0.05 or 0.01 ）. Conclusion There was higher gene mutation rate in the patients of hepatocellular carcinoma complicated with schistosomiasis, which suggests that schistosomiasis can promote p53 mutation proteins over-expression in the histiocytes of HCC. The above evidences indicate that detecting the expressions of p53 i and c-Myc could be considered as reference indexs on evaluating biological behavior of HCC.