细胞外基质蛋白1在原发性肝癌中的表达与预后的关系

Expression of extracellular matrix protein 1 in hepatocellular carcinoma is correlated with prognosis

目的探讨原发性肝癌中细胞外基质蛋白1（extracellular matrix protein 1，ECM1）表达水平与肝癌预后的关系。方法选取77例原发性肝癌手术切除标本，采用免疫组织化学方法检测ECM1表达，并分析ECM1表达与肝癌临床病理特征及预后与复发的关系。结果免疫组织化学染色显示ECM1主要表达在胞质中。肝癌组织中ECM1表达阳性率为74．0％（57／77），与肝癌血管侵犯（x^2=6．523，P：0．011）和TNM分级有关（x^2=6．989，P=0．030），而与患者性别、年龄、血清AFP水平、肿瘤大小、癌灶数、分化程度等指标无明显相关性（P〉0．05）。ECM1阳性表达患者术后总生存率和无瘤生存率明显低于阴性表达者（P=0．016）。多因素分析表明，ECM1表达是影响肝癌总生存和无瘤生存的独立危险因素（RR=3．721，P=0．002；RR=2．323，P=0．031）。结论ECM1的表达与肝癌侵袭转移特性有关，可作为判断肝癌术后预后、复发的指标之一。

Objective To examine the expression of extracellular matrix protein 1 （ECM1） in hepatocellular carcinoma （HCC） and its correlation with prognosis and recurrence of HCC. Methods Immunohistochemistry was used to detect expression of ECM1 in cancerous tissues from 77 HCC patients. The correlation between ECM1 expression and clinicopathologic features and prognosis were analyzed. Results ECM1 is mainly expressed in the cytoplasm of liver cells. The positive rate of ECM1 expression in HCC tissues were 74. 0% （57/77） , and the expression level was significantly correlated with vascular invasion （X^2 =6.523, P =0.011） and TNM stage （X^2 =6.989, P=0.030）. No significant correlation was found between the expression of ECM1 and patient＇s gender, age, AFP level of plasm, tumor size, number of nodules, and tumor differentiation. Patients with positive ECM1 expression have significantly poorer overall survival （OS） and disease-free survival （DFS） after curative resection than those with negative ECM1 expression （P = 0. 016）. The Cox multivariate analysis demonstrated that among the factors analyzed, ECM1 expression is an independent prognostic factors for OS and DFS in HCC patients after a curative resection （RR = 3. 721, P = 0. 002 ; RR = 2. 323, P = 0. 031 ）. Conclusions Positive ECM1 is correlated with postoperative metastasis and invasion of HCC and poor prognosis.