肝细胞癌组织CD133与VEGF及CD34表达预后意义分析

Prognostic significance of expression of CD133,VEGF and CD34 in hepatocellular carcinoma

目的:研究肝癌干细胞标志CD133、血管内皮生长因子(VEGF)及CD34在肝癌组织中的表达及其预后价值。方法:应用免疫组织化学染色方法检测CD133、VEGF和CD34在190例肝癌组织中的表达水平,分析其与各项临床病理指标以及预后之间的相关性。结果:CD133、VEGF和CD34在肝癌组织中的阳性表达率分别为22.1%(42/190)、52.1%(99/190)和50.0%(95/190)。CD133表达与VEGF表达水平、CD34表达水平、肝癌分化程度和镜下血管侵犯相关,42例CD133阳性肝癌组织中,VEGF阳性34例,阴性8例,r=0.785 3,P<0.01;CD34阳性30例,阴性12例,r=0.837 2,P<0.01;低分化肝癌(Ⅲ+Ⅳ)30例,高分化肝癌(Ⅰ+Ⅱ)12例,r=0.842 3,P<0.01;存在镜下血管侵犯33例,无镜下血管侵犯9例,r=0.884 5,P<0.05。生存分析结果表明,CD133阳性组、VEGF阳性组及CD34阳性组肝癌根治术后无瘤生存率均低于阴性组,差异有统计学意义,Log-rank检验统计量值分别为9.31、8.73和8.68,P值分别为0.036、0.012和0.013。结论:肝癌干细胞标志CD133表达影响肝癌新生血管形成以及肝癌分化程度;CD133蛋白表达程度与肝癌术后无瘤生存呈负相关,原因可能与肿瘤细胞低分化以及肿瘤血管微环境有关。

OBJECTIVE： To investigate the expression of CD133,VEGF and CD34 in primary lesions of hepatocellu- lar carcinoma （HCC） and their prognostic significance. METHODS：The expression of CD133, VEGF and CD34 in 190 pa- tients with HCC was detected by immunohistochemical staining. The correlationship between CD133 expression and the clinicopathologic parameters and features after operation was analyzed. RESULTS：The expression of CD133, VEGF and CD34 in HCC tissue was 22.1%（42/190）,52.1%（99/190） and 50.0%（95/190） respectively. There was significant cor- relation between CD133 expression and VEGF expression,CD34 expression, tumor differentiation and micro vessel inva sion （P〈0.05）. There was 34 VEGF positive cases and 8 negative eases in CD133 positive group （r=0. 785 3,P〈 0.01） ;There was 30 CD34 positive cases and 12 negative cases in CD133 positive group （r=0. 837 2,P〈0.01） ;There was 30 cases with poor differentiation （Ⅲ＋Ⅳ ） and 12 cases with higher differentiation （ I ＋ l] ） in CD133 positive group （r=0. 842 3 ,P〈0.01） ;There was 33 cases with microvessel invasion and 9 cases without microvessel invasion in CD133 positive group （r=0. 884 5 ,P〈0.05）. Prognostic analysis demonstrated that the disease-free survival of CD133 positive group was significantly lower than that of CD133 negative group,and Log-rank value was 9.31（P=0. 036） ;Prognostic a- nalysis demonstrated that the disease-free survival of VEGF positive group was significantly lower than that of VEGF negative group,and Log-rank value was 8.73（P=0. 012）;Prognostic analysis demonstrated that the disease-free survival of CD34 positive group was significantly lower than that of CD34 negative group and Log-rank value was 8. 68 （P = 0. 013）. CONCLUSIONS： Cancer stem cell marker CD133 expression significantly influences tumor vessel formation and tumor cell differentiation. The reason why high CD133 expression cause worse disease free survival after operation of pa- tients with HCC may be related with poor differentiation and tumor vessel microenvironment.