不同组织类型原发性肝癌中干细胞分析

Analysis of stem cells in primary liver cancer of different tissue types

目的利用多种抗体对不同组织类型原发性肝癌中的干细胞标志物进行检测,分析其表达规律及其与预后的关系。方法选择2012年1月至2013年12月该院手术切除的肝细胞性肝癌、肝内胆管细胞癌和混合型肝癌、肝硬化结节和癌旁组织进行上皮细胞黏附分子(EpCAM)、CD133和Thy-1/CD90免疫组织化学标记,观察其表达情况,并分析其表达规律与临床病理特征的关系。结果 EpCAM、CD133和Thy-1/CD90在原发性肝癌不同类型中的表达基本一致,具有相关性(P<0.05),且在癌组织的阳性率明显高于肝硬化和癌旁肝组织,差异有统计学意义(P<0.05),其表达与肿瘤分化程度、卫星灶数目、淋巴结转移、脉管或包膜侵犯和临床分期均相关(P<0.05),与患者预后呈负相关,表达越高预后越差(P<0.05),与患者性别、年龄、肿瘤大小、乙型肝炎状态、甲胎蛋白水平均无相关性(P>0.05)。结论在不同类型的原发性肝癌中干细胞阳性率相似,但明显高于肝硬化或肝旁组织,肝细胞可能参与肝癌的发生、发展,并作为判断预后的一项重要指标,也可作为治疗的一个靶点。

Objective To detect the expression of EpCAM,CD133 and Thy-1/CD90,markers of stem cell,in three types of primary hepatic carcinoma and to analyze of its expression and its relationship with prognosis.Methods From January 2012 to December 2013,the expressions of EpCAM,CD133 and Thy-1/CD90 immunohistochemical markers in hepatocellular carcinoma,intrahepatic cholangiocarcinoma and mixed hepatocellular carcinoma（HCC）,cirrhotic nodules and paracancerous tissues were analyzed.And the relationship between the expression pattern and clinicopathological features was analyzed.Results The positive rates of EpCAM,CD133 and Thy-1/CD90 in different types of primary hepatocellular carcinoma were similar and correlated（P〈0.05）,and the positive rate of EpCAM,CD133 and Thy-1/CD90 in primary liver cancer tissues was significantly higher than that of cirrhosis and adjacent liver tissues,the difference was statistically significant（P〈0.05）.The expression was correlated with the degree of tumor differentiation,the number of satellite foci,lymph node metastasis,vascular or capsule invasion and clinical stage（P〈0.05）,and was negative correlation with the prognosis of the patients,the higher the expression,the worse the prognosis（P〈0.05）.But there was no correlation with the gender,age,tumor size,hepatitis B status,and the level of alpha fetal protein in the patients（P〉0.05）.Conclusion The positive rate of stem cells in different types of primary liver cancer is similar,but significantly higher than that of cirrhosis or parathelium.Hepatocytes may be involved in the occurrence and development of liver cancer,and as an important indicator of prognosis,but also as a target for treatment.