不同类型原发性肝癌组织中干细胞的表达及其预后

Expression and prognosis of stem cells in different types of primary liver cancer tissues

目的探讨不同类型的原发性肝癌组织中干细胞表达及其预后。方法回顾性分析2015年1月~2017年1月期间在我院接受治疗的125例原发性肝癌患者的诊治资料。选取患者的手术切除肝细胞性肝癌、肝内胆管细胞癌、肝硬化结节、混合型肝癌和癌旁组织标本,每组25例。对五组标本进行免疫组织化学检测,比较上皮细胞黏附分子(EpCAM)、CD133和CD90在不同类型的组织中的表达及与临床特征和生存期的关系。结果肝内胆管细胞癌、肝细胞性肝癌和混合型肝癌中CD133、EpCAM、CD90的阳性率明显高于肝硬化结节、癌旁组织,差异有统计学意义(P<0.05)。在三组肝癌组织中,CD90表达阳性率明显高于EpCAM、CD133阳性率,但差异无统计学意义(P>0.05)。EpCAM、CD133和CD90阳性表达患者的肿瘤低分化比例、淋巴结转移比例和临床分期为Ⅲ/Ⅳ期的比例明显高于阴性表达者,其中位生存期短于阴性者,差异有统计学意义(P<0.05)。结论干细胞在原发性肝癌中高表达,但在不同类型的肝癌组织中的阳性率接近,干细胞参与了肝癌的发生和进展,是不良预后的标志之一。

Objective To investigate the expression and prognosis of stem cells in different types of primary liver cancer tissues. Methods The clinical data of 125 patients with primary liver cancer who were treated in our hospital from January 2015 to January 2017 were retrospectively analyzed. The hepatocellular carcinoma, intrahepatic cholangiocarcinoma, mixed liver cancer, cirrhotic nodules and adjacent tissues of surgical resection were selected, with 25 cases in each group. Immunohistochemistry was performed on five groups of samples. The expressions of epithelial cell adhesion molecules(EpCAM), CD133 and CD90 in different types of tissues and their relationship with clinical features and survival was compared. Results The positive rates of CD133, EpCAM and CD90 expression in the hepatocellular carcinoma, intrahepatic cholangiocarcinoma, mixed liver cancer were significantly higher than those in cirrhosis nodules and adjacent tissues. The difference between the groups was statistically significant(P<0.05). In the three groups of liver cancer tissues, the positive rate of CD90 expression was significantly higher than that of EpCAM and CD133, but the expression of CD3 in different types of liver cancer tissues was not statistically significant(P >0.05). The proportion of poorly differentiated tumor, lymph node metastasis and clinical stage of stage Ⅲ/Ⅳ in patients with positive expression of EpCAM, CD133 and CD90 was significantly higher than that of patients with negative expression, and the median survival time in patients with positive expression of EpCAM, CD133 and CD90 was shorter than that of negative ones.The difference was statistically significant(P<0.05). Conclusion Stem cells are highly expressed in primary liver cancer, but the positive rates in different types of liver cancer tissues are close. Stem cells are involved in the occurrence and progression of liver cancer, which is one of the signs of poor prognosis.