β-catenin及EZH2阳性表达在原发性肝细胞肝癌中的诊断价值

Diagnostic value of β-catenin and EZH2 positive expression in primary hepatocellular carcinoma

目的探讨β-联蛋白(β-catenin)及zeste 2多梳抑制复合物2亚基增强子(EZH2)阳性表达在原发性肝细胞肝癌(HCC)中的诊断价值和机制。方法选取疑似原发性HCC患者92例,经病理检查确诊为HCC 50例,肝硬化23例,肝血管瘤19例。观察β-catenin及EZH2联合诊断后与甲胎蛋白(AFP)联合诊断的诊断试验结果;检测不同组织中β-catenin及EZH2的阳性表达情况;分析HCC患者组织和血液中β-catenin及EZH2表达的相关性,并观察信号转导及转录激活因子3(STAT3)与二者的相关性。结果以病理检查为"金标准",β-catenin单独诊断HCC的准确度、灵敏度、特异度、阳性预测值、阴性预测值、Kappa值分别为67.4%、78.0%、54.8%、67.2%、67.6%、0.33,EZH2单独诊断HCC的上述指标分别为66.3%、70.0%、61.9%、68.6%、63.4%、0.32;二者与AFP联合诊断HCC的上述指标分别为89.1%、90.0%、88.1%、90.0%、88.1%、0.78。HCC组织中β-catenin和EZH2阳性表达率均高于正常组织、肝硬化组织和癌旁组织,差异均有统计学意义(P<0.05)。血浆中β-catenin及EZH2的表达情况与HCC组织中阳性表达情况均呈正相关(r=0.638、0.920,P<0.05)。HCC组织中STAT3的表达与β-catenin及EZH2的表达均呈正相关(r=0.652、0.423,P<0.05)。结论β-catenin和EZH2在原发性HCC组织中表达水平较高,可以作为原发性HCC的辅助诊断手段,能够提高AFP诊断的准确度,且STAT3可能参与了β-catenin和EZH2的高表达过程。

Objective To investigate the diagnostic value and mechanism ofβ-catenin and enhancer of zeste 2 polycomb repressive complex 2 subunit(EZH2)positive expression in primary hepatocellular carcinoma(HCC).Method A total of 92 patients with suspected primary HCC were enrolled,including 50 cases of HCC,23 cases of liver cirrhosis,and 19 cases of hepatic hemangioma,which were diagnosed by pathological examination.The diagnostic test results ofβ-catenin and EZH2 in parallel with alpha-fetoprotein(AFP)were observed.The positive expression ofβ-catenin and EZH2 in different tissues were detected.The correlation of expression in the tissue and blood was analysed.The correlation between signal transducer and activator of transcription 3(STAT3)and the above two indicators was observed.Result The pathological examination was regarded as the gold standard.The results showed that the accuracy ofβ-catenin as an indicator was 67.4%,sensitivity 78.0%,specificity 54.8%,positive predictive value 67.2%,negative predictive value 67.6%,Kappa value 0.33.The diagnostic results of EZH2 as an indicator were 66.3%,70.0%,61.9%,68.6%,63.4%,and 0.32.The diagnostic results ofβ-catenin and EZH2 paralleled with AFP were 89.1%,90.0%,88.1%,90.0%,88.1%,and 0.78.β-catenin and EZH2 in HCC tissue had higher positive expression than in normal tissues,cirrhotic tissues and adjacent tissues,and the difference was statistically significant(P<0.05).The expression ofβ-catenin and EZH2 in the plasma was positively correlated with the positive expression in HCC tissue(r=0.638,0.920,P<0.05).The expression of STAT3 in HCC tissue was positively correlated with the expression ofβ-catenin and EZH2(r=0.652,0.423,P<0.05).Conclusion The expression levels ofβ-catenin and EZH2 in HCC tissue are high.They can be used as a secondary diagnostic tool for HCC and improve the accuracy of AFP diagnosis.STAT3 may be involved in high expression process ofβ-catenin and EZH2.