E-钙黏蛋白和上皮细胞黏附分子在结节型肝细胞性肝癌大体形态亚型中的表达及相关性研究

Correlated expression of E-cadherin and EpCAM in the gross morphology subtype of nodular hepatocellular carcinoma

目的分析结节型肝细胞性肝癌(hepatocellular carcinoma,HCC)各形态亚型的生存情况,初步探讨E-钙黏蛋白(E-cadherin)和上皮细胞黏附分子(EpCAM)在结节型HCC各亚型中的表达及其相关性。方法选取2008年至2011年在我院手术切除、直径小于5cm且经病理证实为结节型HCC的肿瘤组织,根据其大体形态划分为3个亚组:单个结节组(SN组)61例;单个结节伴有结外生长组(SNEG组)21例;多结节融合型组(CM组)18例。应用免疫组织化学SP法检测E-cadherin蛋白和EpCAM蛋白在结节型HCC各亚型中的表达情况,并初步探讨两者的相关性。采用Kaplan-Meier生存统计分析结节型HCC3种亚型的生存情况。结果结节型HCC中SN组的平均生存时间为(33.5±0.9)月,明显高于SNEG组(24.3±2.6)月和CM组(29.3±2.6)月,SN组与SNEG组比较,差异有统计学意义(P<0.01)。E-cadherin在SN组、SNEG组、CM组中的阳性表达率分别为40.98%(25/61)、9.52%(2/21)、27.78%(5/18)(P<0.05),其中SN组与SNEG组比较,差异有统计学意义(P<0.05)。EpCAM在SN组、SNEG组、CM组中的阳性表达率分别为22.95%(14/61)、52.38%(11/21)、27.78%(5/18)(P<0.05),其中SN组与SNEG组比较,差异有统计学意义(P<0.05)。相关性分析结果显示E-cadherin与EpCAM两者的阳性表达呈负相关(r=-0.580,P<0.01)。结论结节型HCC中的SNEG有潜在的复发风险;E-cadherin低表达与EpCAM高表达提示HCC患者术后预后不良,可作为评估预后的联合诊断指标。

Objective To correlate expression of E-cadherin and EpCAM with the survival prognosis of patients with nodular hepato- cellular carcinoma（HCC）. Methods A total of 100 patients with HCC who underwent surgery at the Affiliated Tumor Hospital of Guangxi Medical University between 2008 and 2011 were selected for this study.These patients had been diagnosed with HCC on the basis of pathology, and they had primary tumors less than 5 cm in diameter.Patients were divided into 3 groups：single nodule （SN） group（n=61 ）,single nodular with extranodular growth（SNEG） group（n=21 ）,and a confluent multinodular（CM） group（n=18）.Expres- sion of E-cadherin and EpCAM was assessed in each group by immunohistochemistry,and Kaplan-Meier survival analysis was per- formed. Results Mean postoperative survival was 33.51-＋0.89 months in the SN group, which was significantly higher than the 24.25-＋ 2.58 months in the SNEG group（P=0.000） and higher （but not significantly） than the 29.30-＋2.59 months in the CM group.The rate of expression of E-cadherin was 40.98%（25/61） in the SN group,9.52%（2/21 ） in the SNEG group,and 27.78%（5/18） in the CM group （P〈O.05）.The corresponding results for EpCAM were 22.95% （14/61）, 52.38% （11/21 ）, and 27.78% （5/18）（P〈O.05 ）.The rates of E-cadherin and EpCAM expression differed significantly between the SN and SNEG groups（P〈0.05 in both cases ）.Pearson correlation analysis showed a negative correlation in the levels of these two proteins （r=-O.580,P〈O.05）. Conclusions Patients in the SNEG group may be at risk of HCC recurrence.Low expression of E-cadherin and high expression of EpCAM are associated with poor prognosis in patients with HCC.The negative correlation be tween E-cadherin and EpCAM expression suggests that these two proteins may be used together to predict prognosis of patients with HCC.