DNA修复基因ERCC1在原发性肝细胞癌组织中的表达及临床意义

Clinical Significance of ERCCl Expression in Primary Hepatocellular Carcinoma

目的:探讨切除修复交叉互补基因1(ERCC1)在原发性肝细胞癌(Hepatocellular carcinoma,HCC)组织中的表达情况及临床意义。方法:应用免疫组织化学方法检测226例HCC癌组织、65例HCC癌旁组织和17例非癌肝组织中ERCC1的表达情况,并分析其与HCC临床病理因素和预后的关系结果:肝癌组织中ERCC1阳性率为44.2%(100/226),显著高于癌旁组织及非癌正常肝组织中的阳性率(分别为16.9%和5.9%,P<0.05)。有门静脉癌栓组的ERCC1阳性率为66.7%,无癌栓组为42.3%,差异具有统计学意义(P<0.05);但ERCC1阳性表达与性别等其他临床病理特征均无关(P均>0.05)。接受根治术的184例患者中,ERCC1阳性率随着中位复发转移时间(TTR/M)的延长而显著降低(x^2=9.630,P=0.047);ERCCI阳性组TTR/M为10.3个月,而阴性表达组为20.3个月,差异具有统计学意义(P<0.05)。多因素生存分析显示,术前谷草转氨酶>2.5倍正常值、病灶最大径>5 cm和ERCCl阳性表达是HCC患者术后复发转移风险增加的独立危险因素。结论:肝癌组织中ERCCl阳性率显著高于癌旁肝组织及非癌肝组织,其阳性表达与门静脉癌栓形成及术后复发、转移风险增高显著相关。

Objective： This study aims to investigate the expression of excision repair cross complementing 1 （ ERCC1 ） of hepatocellular carcinoma （ HCC ） and its clinical significance. Methods： The ERCC1 expression status of 226 patients with HCC, 65 with paraneoplastic tissue, and 17 with normal liver tissues was detected using immunohistochemistry. The correlation between ERCC 1 expression and major clinico-pathological characteristics and prognosis factors of HCC was analyzed. Results： The positive expression rate of ERCC1 in HCC was 44.2 % （ 100 / 226 ）, which was significantly higher compared with the paraneoplastic and non-cancer liver tissues （ 16.9 % and 5.9 %, respectively, all P 〈 0.05 ）. The positive rate of ERCC1 in HCC cases with portal vein invasion was significantly higher compared with those without portal vein invasion （ 66.7 % vs. 42.3 %, P 〈 0.05 ）. Meanwhile, the expression of ERCC1 was not significantly associated with age and other clinical characteristics （ P 〉 0.05, respectively ）. In the HCC group treated with radical resection （184 patients）, the positive rate of ERCC 1 noticeably decreased when the median time to recurrence or metastasis （ TTR/M ） became longer. The group with positive expression of ERCC1 exhibited a shorter TTR/M compared with the group with negative expression （ 10.3 m vs. 20.3 m, P 〈 0.05 ）. The Cox regression model analysis showed that the preoperative serum levels of aspartate amionotransferase ≥2.5 N, tumor size 〉 5 cm, and the positive expression of ERCC 1 were the independent risk factors of recurrence or metastasis of HCC. Conclusion： ERCC 1 expression was obviously higher in HCC than in the paraneoplastic and normal liver tissues, respectively. The overexpression of ERCCI was significantly correlated with the portal vein invasion and the risk of recurrence or metastasis of HCC after radical resection.