AFP血清浓度及肝癌组织中Cx43的表达与肝癌根治切除后早期复发和预后的关系

The relationship between early recurrence after radical resection and the expression of Cx43 in AFP positive and HBV related HCC tissues

目的研究Cx43、CD105、VEGF在不同血清AFP（α-fetoprotein）浓度的乙型肝炎病毒性肝细胞癌（hepatocellular carcinoma，HCC）组织中的表达的关系以及Cx43的表达和R0切除术后复发和预后的关系。方法应用组织芯片技术和免疫组织化学PV-6000两步法检测234例HBV相关HCC组织标本Cx43和CD105、VEGF的表达，应用RT—PCR检测20例HBV相关HCC标本Cx43mRNA的表达，并分析在不同血清AFP浓度下与Cx43的表达与CD105、VEGF的表达的关联以及与HCC患者根治切除术后的复发和预后的关系。结果免疫组织化学法和RT—PCR均检测到Cx43在HCC组织中表达，AFP〈400μg／L的HBV相关HCC组织中Kaplan—Meier分析显示Cx43阳性表达者其1年复发、无瘤生存和总体生存均显著低于阴性表达组（LogRankP=0．001，0．026，0．000），Cox回归分析表明Cx43阳性表达是HCC早期复发和预后（LogRankP=0．049、0．035）的独立影响因子，Cx43阳性表达者CD105、VEGF低表达（P=0．018、0．023），并与组织分化程度（P=0．002），病灶数（P=0．033）血管癌栓（P=0．029）有关。结论Cx43的表达与CD105、VEGF的表达相关，在AFP〈400μg／L的HBV相关HCC的患者中Cx43阴性表达预示早期复发和不良预后。

Objective To study the expressions of Cx43, CD105 and VEGF in HBV related HCC tissues and the relationships between Cx43 expression and recurrence and prognosis after cancer radical resection in HCC patients stratified by serum AFP levels. Methods The expressions of Cx43, CD105, VEGF in 234 HBV related HCC tissues were examined by tissue microarray and two-step methods of PV- 6000 of immunohistochemistry and the expressions of Cx43 in 20 frozen HCC Specimens were examined by RT-PCR. Results Cx43 in HCC tissues was positive as examined by both immunohistochemistry and RT- PCR methods. Positive Cx43 expression is correlated with lower early recurrence （ Log Rank P = 0. 001 ）, longer disease free survival （ Log Rank P = 0. 026） and overall survival （ Log Rank P = 0. 000） as showed by the Kaplan-Meier analysis in patients with AFP 〈 400 μg/L. The expression of Cx43 is an independent prognostic factor. The positive expression of Cx43 related with lower positive expression of CD105 and VEGF （P = 0. 018, 0. 023）, and correlated with histological differentiation （P = 0. 002）, the number of focus （P = 0. 033 ）, blood vessel tumor embolism （ P = 0. 029 ）. Conclusions The expression of Cx43 is correlative with the expression of CD105 and VEGF, and is predictive of HCC early recurrence and poor prognosis after radical hepatectomy in HBV related HCC patients with serum AFP 〈 400μg/L.