上皮细胞黏附分子与肝母细胞瘤患儿病理特征及预后的相关性

Correlation between epithelial cell adhesion molecule and pathological features and prognosis of hepatoblastoma in children

目的:研究上皮细胞黏附分子(epithelial cell adhesion molecule,Ep-CAM)表达与肝母细胞瘤患儿病理特征及预后的相关性。方法:以西安市儿童医院2015年1月至2017年1月收治的62例肝母细胞瘤患儿的肿瘤组织和癌旁组织为研究材料,采用免疫组织化学法检测Ep-CAM表达。分析Ep-CAM表达情况与患儿性别、年龄、病理分期、病理类型等病理特征的关系,并绘制患儿生存曲线,分析上皮细胞黏附分子表达水平与预后的相关性。结果:62例肝母细胞瘤肿瘤组织和癌旁组织EpCAM表达阳性率分别为75.81%和0.00%,差异有统计学意义(P<0.05)。肝母细胞瘤组织中Ep-CAM表达阳性与PRETEXT术前分期有关,与患儿年龄、性别、术前甲胎蛋白水平和病理类型无关。PRETEXT分期Ⅲ期和Ⅳ期患儿肿瘤组织中Ep-CAM阳性表达率显著高于Ⅰ期和Ⅱ期患儿(P<0.05)。Ep-CAM阳性和阴性患儿2年总生存率分别为34.04%(16/47)和86.67%(13/15),差异有统计学意义(P<0.05)。Log-rank分析Ep-CAM阳性和阴性患儿总的生存率差异有统计学意义(P<0.05)。结论:Ep-CAM蛋白在肝母细胞瘤组织中呈高表达,与PRETEXT分期存在相关性,是影响预后的关键因素,可能作为肝母细胞瘤诊断和预后评估的新靶点加以深入研究。

Objective:To study the correlation between the expression of epithelial cell adhesion molecule(Ep-CAM) and the pathological characteristics and prognosis of hepatoblastoma in children.Methods:Ep-CAM expression in 62 cases of hepatoblastoma from January 2015 to January 2017 was detected by immunohistochemistry.The relationships between the Ep-CAM expression and the pathological characteristics(such as gender,age,pathological stage,and pathological type) were analyzed.The survival curve was drawn to analyze the correlation between the expression level of Ep-CAM and prognosis.Results:The positive rates of Ep-CAM expression in 62 cases of hepatoblastoma were 75.81% and 0.00%,respectively(P<0.05).The positive expression of Ep-CAM in hepatoblastoma was related to PRETEXT stage,but not related to age,sex,preoperative alpha-fetoprotein level and pathological type of children.The positive expression rates of Ep-CAM in cancer tissues of children with PRETEXT stage III and IV were significantly higher than those in PRETEXT stage I and II(P<0.05).The 2-year overall survival rates of Ep-CAM positive and negative children were 34.04%(16/47) and 86.67%(13/15),respectively,with significant difference(P<0.05).Log-rank analysis showed that the overall survival rate of Ep-CAM positive and negative children was significantly different(P<0.05).Conclusion:Ep-CAM protein is highly expressed in hepatoblastoma tissues and correlates with PRETEXT staging.Ep-CAM protein is a key factor affecting the prognosis of hepatoblastoma.It may be a new target for diagnosis and prognosis evaluation of hepatoblastoma.