p16和Survivin在肝细胞癌及癌旁组织的表达及临床意义

Expression and clinical significance of p16 and Survivin in hepatocellular carcinoma and paracancerous tissues

目的研究讨论肝细胞癌(HCC)组织与癌旁组织中p16和Survivin的蛋白水平变化及临床意义。方法选取中国人民解放军第四十四医院2016年3月至2017年8月接受手术治疗的HCC患者作为主要研究对象,进行前瞻性研究,收集患者术中切除的HCC及癌旁3 cm组织样本73例。采用免疫组化法检测HCC及其癌旁组织中p16蛋白和Survivin蛋白的表达水平。检测p16和Survivin在肝细胞癌和癌旁组织中的阳性率;HCC组织中p16和Survivin蛋白水平与临床病理因素的关系;计算p16和Survivin蛋白表达HCC组织中的凋亡指数(AI);Pearson分析两种蛋白表达之间的关系。结果收集HCC组织样本及癌旁组织样本各73例。p16蛋白在HCC组织中的阳性率为16.43%,显著低于癌旁组织的(53.42%,P<0.05);Survivin蛋白在HCC组织中的阳性率为80.82%,显著高于癌旁组织的(10.96%,P<0.05);单因素分析显示:HCC组织中Survivin和p16蛋白水平与AFP、门静脉癌栓形成及肝内转移有关(P<0.05);Survivin阳性HCC组织中AI为0.92±0.28,显著小于阴性组织的(3.34±0.67,P<0.05);P16阳性HCC组织中AI为1.35±0.43,显著小于阴性组织的(3.18±0.71,P<0.05);HCC中Survivin与p16蛋白表达呈负相关(r=-0.535,P<0.001)。结论在HCC组织中,Survivin与p16蛋白水平异常表达,且Survivin与p16存在负相关,能够共同影响HCC组织细胞的增殖凋亡,对临床探寻HCC的新治疗靶点具有重要指导意义。

Objective To study the changes of protein levels of p16 and Survivin in hepatocellular carcinoma （HCC） tissues and adjacent tissues and its clinical significance. Methods The HCC patients who received surgical treatment in our hospital from March 2016 to August 2017 were selected as the main research subjects in this prospective study and 73 samples of HCC and paracancerous 3 cm tissue samples were collected during the operation. The expression of p16 and Survivin protein in HCC and its paracancerous tissues were detected by immunohistochemistry. The positive rate of p16 and Survivin in hepatocellular carcinoma and para cancer tissues, the relationship between the level of p16 and Survivin protein in HCC tissues and the clinicopathological factors, and the expression of p16 and Survivin protein to express the apoptosis index （AI） in HCC tissues were calculated. Pearson analysis of the relationship between the expression of two proteins was performed. Results HCC tissue samples and paracancerous tissue samples were collected from 73 cases. The positive rate of p16 protein in HCC tissue was 16.43%, significantly lower than that in paracancerous tissue （53.42%, P 〈0.05）, and the positive rate of Survivin protein in HCC tissue was 80.82%, significantly higher than that in para cancerous tissue （10.96%, P 〈0.05）. Single factor analysis showed that the level of Survivin and p16 protein in HCC tissues was associated with AFP, the formation of portal vein tumor thrombus and intrahepatic metastasis （ P 〈0.05）, and AI in Survivin positive HCC tissues was 0.92±0.28, significantly less than that of negative tissues （3.34±0.67, P 〈0.05）, and AI in P16 positive HCC tissues was 1.35±0.43, significantly less than that of negative tissues （3.18±0.71, P 〈0.05）. There was a negative correlation between Survivin and p16 protein expression in HCC （ r =-0.535, P 〈0.001）. Conclusion In HCC tissues, the expression of Survivin and p16 protein is abnormal, and there is a negative correlation between Survivin and p16. It can affect the proliferation and apoptosis of HCC tissue cells. It is of great significance for the clinical exploration of the new therapeutic targets of HCC.