肝癌分化程度与肝脏CT强化特点及CD34、p53、GPC3、CK19、Ki-67表达的关系

The relationship between differentiation degree of liver cancer and the hepatic characteristic on enhanced CT and the expression of CD34, p53, GPC3, CK19 and Ki-67

目的探讨不同分化程度的肝癌患者的计算机体层摄影(CT)增强特点及CD34、p53、GPC3、细胞角蛋白19(CK19)、Ki-67免疫组化指标的表达规律。方法回顾性分析40例肝癌患者的临床资料。统计患者的肝癌分化程度,比较不同分化程度肝癌患者的CK19、CD34、p53、GPC3、Ki-67表达情况;分析肝脏CT平扫+增强扫描的表现,肝组织的三期动脉CT值及病灶有无包膜、有无边界、是否均匀强化,淋巴结转移情况,肿瘤远处转移情况,TNM分期情况;比较不同甲胎蛋白水平的肿瘤分化程度。结果 40例肝癌患者低分化12例,中低分化4例,中分化20例,中高分化0例,高分化4例。12例低分化患者的CK19表达:-7例,+-1例,+4例;4例低中分化:-1例,+-2例,+1例;20例中分化:-18例,+2例;4例高分化:-3例,+1例。不同分化程度患者的CK19表达情况比较,差异有统计学意义(P﹤0.05)。Spearman相关性分析显示,肝癌的分化程度与Ki-67表达众数呈负相关(r=-0.344,P﹤0.05)。低分化、低中分化、中分化、高分化患者均匀强化的例数分别为0例、1例、4例、4例,不均匀强化的例数分别为12例、3例、16例、0例,两者比较,差异有统计学意义(P﹤0.05)。结论 CK19阳性表达程度及病灶强化均匀情况可能与肝癌分化程度有关。

Objective To investigate the enhancement characteristics of computerized tomography(CT)and the expression patterns of immunohistochemical indexes such as CD34,p53,GPC3,cytokeratin 19(CK19)and Ki-67 in liver cancer patients with different differentiation degrees.Method The clinical data of 40 patients with liver cancer were analyzed retrospectively.The differentiation degree of liver cancer was statistically analyzed,and the expression of CK19,CD34,p53,Ki-67 and GPC3 in liver cancer patients with different differentiation degrees was compared.The liver CT plain scan+enhanced scan,the third-stage arterial CT value of liver tissue and whether the lesion has capsule,boundary or uniform enhancement,with or without lymph node metastasis,distant metastasis and the TNM stage were all analyzed.The differentiation degree of tumor in patients with different alpha-fetal protein levels was compared.Result Among 40 patients,there are 12 cases poorly differentiated,4 cases moderately or poorly differentiated,20 moderately differentiated,0 moderately or high differentiated,4 cases high differentiated.Among the 12 low differentiated cases,CK19 expression:-7 cases,+-1 case,+4 cases;among the 4 moderately or poorly differentiated cases:-1 case,+-2 cases,+1 case;among the 20 moderately differentiated cases:-18 cases,+2 cases;among the 4 high differentiated cases:-3 cases,+1 case.The difference of CK19 expression between patients with different differentiation degree of tumor was statistically significant(P<0.05).Spearman correlation analysis showed that differentiation of liver cancer was negative relative with expression of Ki-67(r=-0.334,P<0.05).Among the low differentiated,moderately or poorly differentiated,moderately differentiated and high differentiated patients,the uniformity enhancement cases were 0,1,4,and 4 cases respectively,nonuniformity enhancement cases were 12,3,16 and 0 case,the difference was statistically significant(P<0.05).Conclusion The positive expression of CK19 anduniform enhancement of lesionsmay be related to the differentiation degree of liver cancer.