干细胞标记物联合血管标记物在肝细胞癌中的表达及临床意义

Expressions and clinical significance of putative hepatic stem cell biomarkers associated with tumourangiogenesis

目的研究肝癌干细胞与肿瘤血管生成的关系及其临床意义。方法采用免疫组织化学染色检测61例原发性肝癌组织中CD90、CD133和CD34的表达水平，探索其与肝癌患者术后生存预后间的关系。将患者分为3组，1组为高危组，CD90表达和（或）CDl33合并肿瘤微血管密度（microvesseldensity，MVD）高表达。2组为中危组，CD90表达和（或）CD133而MVD低表达或不表达CD90和CD133，但MVD高表达。3组为低危组，不表达CD90和CD133且MVD低表达。结果肝癌组织标本中CD90、CD133阳性率分别为29．5％（18／61）、31．1％（19／61），CD90和（或）CD133表达阳性率为45．9％（28／61），有血管侵犯、肿瘤分化程度Ⅲ／Ⅳ、包膜不完整、TNM分期m／Ⅳ患者CD90和（或）CD133表达阳性率明显高于无血管侵犯、肿瘤分化程度Ⅰ／Ⅱ、包膜完整、TNM分期Ⅰ／Ⅱ患者，CD90／CD133与MVD表达在肝癌组织中表达呈正相关（r=0．5，P〈0．05），与不表达CD90和CD133且MVD低表达相比，表达CD90和（或）CD133且MVD高表达的患者的术后总体生存率和无瘤生存率更差。结论高表达肝癌干细胞表面标记物和肝癌血管生成有一定关系，两者结合可以预测肝癌患者术后生存状况。

Objective To investigate the expression of liver cancer stem cells （LCSCs） biomarkers and tumour angiogenesis in patients with hepatocellular carcinoma （ HCC ） and its clinical significance. Methods Immunohistochemistry was used to detect the expression of CD90, CD133 and CD34 in tumor tissues from 61 patients with HCC undergoing curative hepatectomy. Results The positive rates of CD90 and CD133 in HCC tissues were 29. 5% （ 18/61 ） and 31.1% （ 19/61 ）, the positive rates of CD90 and/or CD133 in HCC were 45. 9% （28/61）. The positive rate of LCSCs biomarkers in patients with vascular invasion, tumor differentiation Ⅲ/Ⅳ, non-complete encapsulation, and TNM stage Ⅲ/Ⅳ was significantly higher than those with non-vascular invasion, tumor differentiation Ⅰ/ Ⅱ, with complete encapsulation, and TNM stage Ⅰ/Ⅱ. There were a significant positive correlation between LCSCs biomarkers expression and MVD（ r = 0. 5 ,P 〈 0. 05）. As compared with negative LCSCs expression and MVD low group, patients with a positive LCSCs biomarkers expression and MVD high in tumours had significantly lower overall survival （OS） and poor relapse-free survival （RFS）. Conclusions High expression levels of LCSCs biomarkers are related to markers of angiogenesis microvessel density （MVD）. By combining two of those we can classify paitients and anticipate the prognosis after surgery.