EP-CAM、N-CAM1及C-KIT与原发性肝癌分级、转移及患者预后的关系

Relationship between EP-CAM, N-CAM1, C-KIT and the Grade, Metastasis and Prognosis of Primary Liver Cancer

目的探讨上皮细胞黏附分子（epithelialcellularadhesionmolecule，EP-CAM）、神经细胞黏附分子1（neural cell adhesion moleculel，N-CAMl）及C-K／T与原发性肝癌分级、转移及患者预后的关系。方法收集2008年1月～2014年9月重庆三峡中心医院收治的80例原发性肝癌患者作为观察组，选择同期行手术治疗的50例肝硬化及乙型肝炎患者作为对照组，均收集患者病理组织标本，采用免疫组化法测定肝癌及对照组织EP-CAM、N-CAMl、C-KIT表达情况，并收集所有肝癌患者的临床及随访资料，分析EP-CAM、N-CAMl、C-KIT与原发性肝癌临床病理特点及患者预后的关系。结果观察组EP-CAM、N-CAMl、C-KIT阳性表达率均高于对照组（P〈0．05）；高AFP水平、无包膜或包膜不完整、低中分化肿瘤、临床分期为Ⅲ～Ⅳ期、病理类型为胆管上皮癌、混合型肝癌及出现肝内外转移的肝癌患者EP-CAM、N-CAMl、C-KIT阳性率较高（P〈0．05）；Pearson相关分析显示：肝癌患者肝组织EP．CAM与N-CAMl、C-KIT表达呈正相关（P〈0．05），肝组织N-CAMl与C-KIT表达呈正相关（P〈0．05）；肝癌患者1、2、3年生存率分别为72．50％、53．75％、37．50％，随访3年存活患者，EP-CAM、N-CAMl、C-KIT阳性率低于1年及2年存活患者（P〈0．05）。结论EP-CAM、N-CAMl、C-KIT表达水平与原发性肝癌患者AFP水平、肿瘤包膜情况、分化程度、临床分期、组织学类型及预后均有一定的关系，且参与肝癌侵袭、转移过程。

Objective To investigate the relationship between epithelial cell adhesion molecule （EP-CAM）, nerve cell adhesion molecule 1 （N-CAM1）, C-KIT and the grade, metastasis and prognosis of primary liver cancer. Methods Eighty patients with primary liver cancer who were ad- mitted to our hospital during the period from January 2008 to September 2014 were selected as an observation group. Another 50 patients with hepatic cirrhosis and hepatitis B who underwent surgical treatment during the same period served as a control group. The pathological tissues were collected from patients to determine the expression of EP-CAM, N-CAM1 and C-KIT in liver cancer and con- trol tissues by the immunohistochemical method. The clinical and follow-up data of all patients with liver cancer were collected to examine the relationship between EP-CAM, N-CAM1, C-KIT and clinical pathological feature and prognosis of primary liver cancer. Results The positive expression rates of EP-CAM, N-CAM1 and C-KIT in the observation group were higher than in the control group （P 〈0. 05） . The positive rates of EP-CAM, N-CAM1 and C-KIT were relatively higher in patients with high AFP level, patients without capsule or with incomplete capsule, patients withlowly or moderately differentiated tumors, patients with tumors in clinical stage III - IV, patients with pathological type of cholangiocarcinoma, patients with mixed liver cancer and patients with in- trahepatic and extrahepatic metastasis （P 〈 0. 05 ） . Pearson correlation analysis showed that the ex- pression of EP-CAM in liver tissues of patients with liver cancer was positively correlated with the ex- pression of N-CAM1 and C-KIT （ P 〈 0.05） , and the expression of N-CAM1 was positively correla- ted with the expression of C-KIT （P 〈 0. 05 ） . The 1-, 2-and 3-year survival rates of patients with liver cancer were 72.50 %, 53.75 % and 37.50 %, respectively. The positive rates of EP-CAM, N-CAM1 and C-KIT were lower in survivors followed-up for 3-years were lower than in 1-year and 2- year survivors （P 〈 0.05） . Conclusion The expression levels of EP-CAM, N-CAM1 and C-KIT are correlated with the AFP level, presence of tumor capsule, differentiation, clinical stage, his- tological type and the prognosis of patients with primary liver cancer, and they are involved in the nrocesses of invasion and metastasis of liver cancer.