HNF4a基因在肝细胞癌中的表达及其与预后的相关性

Expression of HNF4a gene and its prognostic value in hepatocellular carcinoma

目的探讨肝细胞癌患者组织中HNF4a蛋白表达与无病生存期和总生存期的关系。方法免疫组化检测肝癌组织中HNF4a蛋白,观察172例患者肝细胞癌组织中HNF4a的表达情况;HNF4a蛋白表达水平与各临床病例参数间的关系、患者无病生存期和总生存期的关系,建立回归模型。结果 HNF4a阳性率为81.98%(141/172),HNF4a基因表达与患者性别、年龄、HBsAg、肝硬化、肿瘤大小、TNM分期以及转移复发无相关性(P>0.05),与AFP、肿瘤病理分级存在相关性(P<0.05)。HNF4a蛋白高表达患者中无病生存期为22个月,HNF4a低表达患者无病生存期为4个月,差异有统计学意义(P<0.05)。总生存期分析显示,HNF4a蛋白表达是其风险因素(P<0.05)。结论 HNF4a蛋白低表达肝癌患者生存期降低的风险显著升高,HNF4a表达与肝细胞发生发展密切相关,有可能是肝细胞癌转移复发以及预后的参考指标。

Objective To investigate the expression of hepatocyte nuclear factor 4 alpha（HNF4a） in hepatocellular carcinoma（HCC）,and explore its prognostic value in metastasis and recurrence of HCC by analyzing its relationships with disease-free survival（DFS）and overall survival（OS）.Methods Expressions of HNF4a in 172 HCC tissues was detected using immunohistochemistry.To establish the regression model of HNF4a protein expression with clinical pathological parameters,DFS and OS in HCC patients.Results The positive rate of HNF4a was 81.98% in 141/172 HCC patients.Moreover,HNF4a gene expression was significantly correlated with alpha fetal protein（AFP） and pathologic grading of cancer（P〈0.05）,while showed no significantly correlations with sex,age,hepatitis B surface antigen（HBsAg）,liver cirrhosis,tumor size,tumor node metastasis（TNM）stage,metastasis and recurrence,respectively（all P〉0.05）.The DFS was 22.0 months in patients with high HNF4a protein expression and 4.0 months in patients with low HNF4a expression（P〈0.05）.OS analysis showed that HNF4a protein expression was a risk factor（P〈0.05）.Conclusion HNF4a expression was significantly positively correlated with the survival in HCC patients,which might be a reference index for the recurrence and prognosis of HCC.