复发性肝细胞癌的细胞克隆来源及其与复发时间的关系

Clonal origin of recurrent hepatocellular carcinoma and its relationship with time of recurrence

目的了解复发性肝细胞癌的细胞克隆来源及其与复发时间的关系。方法采用ＰＣＲ方法测定ｐ５３基因突变，并结合Ｐ５３蛋白及病理类型作为判断细胞克隆来源的指标。结果单中心性复发癌和多中心性复发癌的平均复发时间分别为（６５±３．２５）个月和（３３．８±１７．８）个月（Ｐ＜０．０１）。术后２年内多为单中心性复发，而术后２年后均为多中心性复发（Ｐ＜０．０１）。结论多中心性复发癌的复发时间明显长于单中心胜复发癌；对多中心性复发，应采用积极的方法达到再次根治性的治疗。

Objective To understand the clonal origin of recurrent hepatocellular carcinoma (HCC) andits relation with recount the of HCC. Method Fifteen recurrent incidents in 12 postoperative patients studied by PCR analysis for p53 gene mutation, immunohistochemical analysis of P53 expression, and pathologicalclassification. Results The average recurrent time of recurrent lesions of unicentric origin was (6.5±3. 25 )months, and that of lesions of multicentric origin was (33. 8±17.8) months(P<0. 001). Most incidents of recurrence within 2 years after primary operation were of nnicentric origin; and all incidents of recurrence over 2years after operation were of multicentric origin (P< 0. 01 ). Conclusion The time between operation and recurrence of recurrent HCC with multicentric origin is significantly longer than that of recurrent HCC with unicentric origin. Recurrent lesions in patients whose HCCs recur over 2 years after primary operation are always of multicentricorigin. For these patients, the second radical cure can be get by an active therapy.