雌激素受体α在乙肝相关性肝癌组织中的表达及其临床意义

Expression of estrogen receptor α in hepatitis B-related hepatocellular carcinoma and its clinical significance

目的 研究雌激素受体α（ERα）及磷酸化ERα（p-ERα）在肝癌组织中的表达及临床意义,并探讨ERα、p-ERα表达与白细胞介素6（IL-6）之间的相关性.方法 采用免疫组化方法检测77例肝癌组织中ERα、p-ERα及IL-6的表达,并分析ERα与肝癌临床病理资料及预后之间的关系.结果 肝癌组织ERα、p-ERα以及IL-6的阳性率分别为39.0%（30/77）、45.4%（35/77）、72.7%（56/77）.ERα、p-ERα表达与IL-6表达呈负相关（r=-0.468,P＜0.05;r=-0.370,P＜0.05）.肿瘤直径≤5 cm、血清甲胎蛋白水平＜400μg/L、肿瘤有完整包膜及无镜下癌栓患者ERα阳性率明显高于肿瘤直径＞5 cm、血清甲胎蛋白水平≥400μg/L、肿瘤无完整包膜及有镜下癌栓患者（P＜0.05）.ERα阳性与ERα阴性肝癌患者术后总生存率分别为66.7%和23.4%（P＜0.01）,ERα阳性与ERα阴性肝癌患者术后无瘤生存率分别为83.3%和57.4%（P＜0.05）.结论 ERα阳性的肝癌患者肿瘤生物学特性以及预后较阴性患者好,ERα在肝癌中的作用可能与 IL-6相关.

Objective To investigate the expression and its clinical significance of estrogen receptor （ERα） and phosphorylated estrogen receptor （p-ERα） in patients with hepatocellular carcinoma. The associations between ERα, p-ERα and IL-6 were also analyzed. Methods Immunohistochemistry was used to detect the expression of ERα, p-ERα and IL-6 in tumor tissues from 77 cases with hepatocellular carcinoma. The relations between ERα and the clinical pathological parameters and prognosis were also analyzed. Results The positive rates of ERα, p-ERα and IL-6 in hepatocellular carcinoma were 39. 0% （30/77）, 45.4% （35/77） and 72. 7% （56/77）, respectively. The expression of ERα and p-ERα were negatively correlated with the expression of IL-6 （r= -0.468, P ＜ 0.01; r = - 0.370, P ＜ 0.01,respectively）. The positive rate of ERα in patients with tumor size≤5 cm, serum level of alpha-fetoprotein ＜ 400 μg/L, with complete encapsulation and non-microvascular invasion was significantly higher than those with tumor size ＞5 cm, serum level of alpha-fetoprotein ≥400 μg/L, non-complete encapsulation and with microvascular invasion （ all P ＜ 0. 05）. The overall survival rates of ERα-positive and ERα-negative patients were 66. 7% and 23.4% （ P ＜0. 05 ）. And the disease-free survival rates of ERα-positive and ERα-negative patients were 83. 3% and 57. 4% （P ＜0. 05）. Conclusions The tumor biological features of ERα-postive patients are better than that of ERα-negative patients. The role of ERα in hepatocellular carcinoma may be related to IL-6 level.