肝细胞癌中ErbB3表达水平与肝癌切除术后辅助性TACE疗效的关系

Relationship between the expression level of ErbB3 in hepatocellular carcinoma and the efficacy of adjuvant TACE after hepatectomy

目的研究肝细胞癌中人类表皮生长因子受体3(ErbB3)表达水平与肝癌切除术后辅助性经肝动脉化疗栓塞(TACE)疗效的关系.方法回顾性分析徐州医科大学附属医院2014年6月至2015年12月收治的102例肝癌患者的临床资料.根据术后是否行辅助性TACE分为TACE组(术后行辅助性TACE,49例)和对照组(术后未行辅助性TACE,53例).采用SP免疫组织化学染色法检测肝癌组织中ErbB3表达水平,并据其将本组患者分为ErbB3高表达者77例和ErbB3低表达者25例.比较TACE组与对照组的一般临床资料和术后1、2、3年的生存率,采用Cox回归分析影响患者术后生存率的因素.结果 TACE组与对照组术后1、2、3年的生存率分别为69.07%、51.82%、45.06%和64.15%、40.65%、36.58%,差异无统计学意义(P>0.05);对于ErbB3高表达者,TACE组术后1、2、3年的生存率分别为72.54%、52.24%、49.17%,高于对照组的55.00%、25.93%、23.05%,差异有统计学意义(P<0.05);对于ErbB3低表达者,TACE组术后1、2、3年的生存率分别为58.33%、50.0%、33.33%,低于对照组的92.31%、84.62%、76.92%,差异有统计学意义(P<0.05).Cox回归分析结果显示:在ErbB3高表达的肝癌患者中,肝硬化、肿瘤直径大是影响患者术后长期生存的危险因素,术后辅助性TACE是患者术后长期生存的保护因素(P<0.05).在ErbB3低表达的肝癌患者中,HbsAg阳性、肿瘤直径大、肿瘤数量多是影响肝癌患者术后长期生存的危险因素(P<0.05).结论肝癌切除术后给予辅助性TACE可延长肿瘤组织中高表达ErbB3患者的生存期,而对于肿瘤组织中低表达ErbB3的患者,术后辅助性TACE不能明显改善患者预后.

Objective To investigate the relationship between the expression of ErbB3 in hepatocellular carcinoma and the efficacy of adjuvant transcatheter arterial chemoembolization(TACE) after hepatectomy. Methods The clinical data of 102 patients with liver cancer admitted to the Affiliated Hospital of Xuzhou Medical University from June 2014 to December 2015 were retrospectively analyzed. According to whether or not the adjuvant TACE was performed, the patients were divided into TACE group(49 patients with adjuvant TACE) and control group(53 patients with adjuvant TACE after operation). The expression level of ErbB3 was detected by SP immunohistochemical staining, and the patients were divided into 77 cases with high expression of ErbB3 and 25 cases with low expression of ErbB3. The general clinical data of TACE group and control group and the survival rate of 1, 2, and 3 years after operation were compared. The factors affecting the postoperative survival rate were analyzed by Cox factor regression. Results The 1, 2, and 3 year survival rates of TACE group and control group were 69.07%, 51.82%, 45.06%, and 64.15%, 40.65%, and 36.58%, respectively. The difference was not statistically significant(P>0.05);high expression of ErbB3 The survival rates of the TACE group at 1, 2, and 3 years were 72.54%, 52.24%, and 49.17%, respectively, which were higher than the control group's 55.00%, 25.93%, and 23.05%. The difference was statistically significant(P<0.05). For patients with low ErbB3 expression, the survival rates of the TACE group were 58.33%, 50.0%, and 33.33%, respectively, which were lower than those of the control group(92.31%, 84.62%, and 76.92%). The difference was statistically significant(P<0.05). Cox regression analysis showed that in patients with liver cancer with high expression of ErbB3, cirrhosis and large tumor diameter were the risk factors for long-term survival. Postoperative adjuvant TACE was the protective factor for long-term survival after operation(P<0.05). In patients with liver cancer with low expression of ErbB3, HbsAg positive, large tumor diameter and large number of tumors were the risk factors for long-term survival of patients with liver cancer(P<0.05).Conclusions The administration of adjuvant TACE after liver cancer resection can prolong the survival of patients with high expression of ErbB3 in tumor tissues. For patients with low expression of ErbB3 in tumor tissues, postoperative adjuvant TACE can not significantly improve the prognosis of patients.