肝癌前体细胞snail表达与肝癌术后预后相关性研究

Prognostic Value of Hepatpcelluar Carcinoma progenitor cells expressing Snail in patients after Hepatectomy

目的本研究通过检测CD44分子和Snail蛋白在HCC中的表达,探究CD44和Snail蛋白与HCC患者临床病理因素以及术后预后的关系。方法利用免疫组化方法检测252名肝癌术后患者癌及癌旁组织CD44和Snail蛋白的表达。结果 CD44阳性表达125例,见于细胞膜和细胞浆,Snail蛋白阳性表达121例见于细胞浆和细胞核。二者阳性表达均显著高于癌旁组织。CD44和Snail蛋白共阳性表达89例,其1-,3-,5年生存率为49.4%,31.5%,24.7%,1-,3-,5年复发率为59.9%,76.6%,81.6%。COX多因素分析中,CD44和Snail共阳性表达是生存复发的独立危险因素。结论 CD44和Snail共阳性表达与肝癌的复发和侵袭性密切相关,可作为预测肝癌患者术后预后的指标。

Objective To investigate the prognositic significance of espressions of CD44 and Snail in patients with hepatocelluar carcinoma （ HCC）. Methods Data were retrospectively collected from 252 consecutive patients who underwent hepatectomy for HCC between January 2008 and June 2008 at the Eastern Hepatobiliary Surgery Hospital （EHBH）. The expressions of CD44 and Snail were analyzed by using S-P immunohistoehemical technique. According to the expressions of CD44 and Snail, both positive expressions of CD44 and Snail were defined as positive group. The prognostic risk factors for tumor recurrence and overall survival （OS） of the two group were compared. Results The positive expression of CD44 was located in membranes and cytoplasma, while that of that of Snail was located in cytoplasma and nucleus. The incidence of CD44 and Snail expression were 49.6% and 48.0% respectively, which were statistically higher than the expressions in para-carcinoma tissues. There were 89 patients whose expressions of CIM4 and Snail were both positive. The comparision of clinicalpathological characteristics between the positive and negative groups showed that the positive group had a higer alanine aminotransferase （ALT） , proportion of muliple tumors, pTMN staging, and positive rate for MVI. The postoperative 1-,3-,5-year recurrence rates 49. 4% , 31.5% , 24. 7% for positive group and 74. 8% , 56. 5% , 44. 3% for negetive group. And 1-,3-,5-year survival rates were 59. 9% vs. 40. 8% , 76. 6% vs. 63.6% , 81.6% vs. 68.2% for the two group respectively. Multivariate analyses of prognostic factors indicated that positive expression of CD44 and Snail was an independent prognostic factor for both recurrence and survival of overall patients （HR, 1.507, 95% CI, 1.074-2. 114; 1.744, 1.247-2.440）. Conclusion Positive expression of CD44 and Snail was closly related to recurrence and invasiveness of HCC, and it may serve as a predictive factor for patients after hepatectomy .