肝再生与肝癌复发关系的初步探讨

Preliminary study of relation between liver regeneration and recurrence of hepatocellular carcinoma.

目的 探讨肝癌切除、肝再生过程中转化生长因子－ β１ 含量的变化及对肝癌复发的影响。方法 用夹心酶联免疫吸附测定法，检测１５ 例肝癌切除病人手术前后外周血浆转化生长因子－β１ 的浓度，同时用逆转录聚合酶链反应，检测了这１５ 例肝癌组织和癌旁肝组织中转化生长因子－βⅡ型受体ｍＲＮＡ的表达。结果 肝癌病人手术后血浆转化生长因子－ β１ 的浓度平均为（５２０ ±３１０）μｇ／Ｌ，较术前（６２±５２）μｇ／Ｌ明显增高（Ｐ＜０．０１）；转化生长因子－βⅡ型受体ｍＲＮＡ阳性表达在肝癌组织为４／１５，癌旁肝组织为１２／１５ ，在肝癌组织中表达显著降低（ Ｐ＝０ ．００８４） 。结论 肝再生过程产生大量转化生长因子－ β１，由于其受体在肝癌细胞表达降低，而失去对可能残留肝癌细胞增殖的抑制作用；高浓度转化生长因子－ β１ 的免疫抑制作用和促进体内血管形成作用反而造成有利于肝癌复发的环境。

Objective The change in amount of TGF-β1 in the process of liver regeneration and its effect on the recurrence of hepatocelluar carcinoma (HCC) was investigated. Method The plasma TGF-β1 in 15 patients with HCC before and after hepatectomy was measured by sandwich enzyme linked immunosorbent assay (SELISA), and the expression of transforming growth factor type Ⅱ receptor (TGF-βRⅡ) mRNA in HCC tissue and its surrounding liver tissue of these 15 cases was separately detected using reverse transcription polymerase chain reaction. Results The average concentration of plasma TGF-β1 in HCC after operation was (520±310)μg/L, which was obviously higher than that before operation 〔(62±52)μg/L〕(P<0.01). The positive expression rate of TGF-βRⅡmRNA was significantly lower in HCC tissue (4/15) than in the surrounding liver tissue (12/15) (P=0.0084). Conclusion High amount of TGF-β1 is produced in the process of liver regeneration. Because of the decreased expression of TGF-βRⅡby tumoral hepatocyte, TGF-β1 loses the ability of inhibiting proliferation of possible residual tumor cells. On the other hand, the immunodepression and induction of angiogenesis in vivo caused by the high concentration of TGF-β1 might establish an environment facilitating the recurrence of HCC.