化疗栓塞对肝细胞癌上皮型钙粘蛋白表达的影响

The effect of chemoembolization on E-cadherin expression of primary hepatocellular carcinoma

目的 研究上皮型钙粘蛋白 (E cad)在原发性肝细胞癌 (PHC)中表达的意义以及不同化疗栓塞方法对其表达的影响。方法 7种不同组织学类型的PHC共 98例 ,单纯手术 5 7例 ,4种介入治疗后Ⅱ期切除 41例。采用SABC免疫组化方法 ,检测各样本中E cad的表达 ,并与临床转移情况对照。结果 E cad阳性、阴性表达者转移率分别为 43.3% ,70 .4% (x2 =4.2 2 ,P <0 .0 5 ) ,介入治疗组及其A ,B ,C ,D各组和单纯手术组E cad阳性率分别为 6 5 .8% ,42 .9% ,6 2 .5 % ,73.3% ,72 .7% ,5 4.4% (介入组分别与单纯手术组相比 ,P值均 >0 .0 5 )。梁索型、透明细胞型E cad表达较高 ,但介入治疗后这 2型E cad表达下降 ,未分化型、实体型E cad表达较低 ,但介入治疗后这 2型E cad表达增高 ,从Ⅰ级到Ⅳ级E cad表达有递减趋势 ,但介入治疗后E cad表达有递增趋势。介入组与单纯手术组转移率分别为 48.8% ,5 6 .1% (x2 =0 .5 2 ,P >0 .2 5 )。结论 E cad高表达可抑制PHC侵袭转移潜能 ,其可作为PHC预后评估指标。化疗栓塞对肝细胞癌E cad表达的影响存在组织学差异。

Objective To study the significance of E cadherin (E cad) expression of primary hepatocellular carcinoma (PHC), and the effect of the different chemoembolization treatment on E cad.Methods Ninety eight histopathological verified PHC specimens were obtained. The patients were treated with surgical resection alone (57 cases), and second stage surgical resection after four kinds of chemoembolization (41 cases). Strept avidin biotin complex (SABC) immunohistochemical staining with monoclonal antibody against human E cad was used to observe the E cad in all specimens. The experimental results were compared with the surgical and clinical findings. Results The metastatic rates in E cad(+) and (-) were 43.3%, 70.4% respectiely ( x 2 =4.22, P <0.05), 65.9% of total chemoembolization, 42.9% of pure chemotherapy, 62.5% of chemotherapy combined with iodized oil, 73.3% of chemotherapy combined with iodized oil, spongia gelatini absorbens (sga), 72.7% of chemotherapy combined with ethanol, iodized oil and sga, 54.4% of surgical resection alone were positive for E cad (interventional groups were compared with surgical resection alone, all P >0.05). The E cad expression of trabecular and clear cell PHC was higher than that of solid and poorly differentiated PHC. After chemoembolization, the E cad expression of the former decreased, the latter increased. The E cad expression decreased as pathologic grades increased. After chemoembolization, the E cad expression increased as pathological grades increased. The metastatic rates in interventional group and surgical resection alone were 48.8%, 56.1% respectively ( P >0.05). Conclusions The increased expression of E cad would restrain PHC from metastasis. It could act as a prognosis predictive marker. The effect of chemoembolization on E cadherin expression of primary hepatocellular carcinoma had histopathologic difference.