前列腺特异性膜抗原表达水平对原发性肝细胞癌预后的预测价值

Prognostic value of prostate-specific membrane antigen expression level for hepatocellular carcinoma

目的探讨前列腺特异性膜抗原(PSMA)表达水平与原发性肝细胞癌(HCC)临床病理特征和预后的关系。方法回顾性分析2014年1月—2015年12月中南大学湘雅医学院附属海口医院收治的100例HCC患者的临床资料,采用免疫组织化学染色(IHC)法检测HCC组织中PSMA和血管标记蛋白CD31的表达,根据PSMA表达水平将患者分为PSMA低表达组(n=72)和PSMA高表达组(n=28),分析HCC组织中PSMA表达水平与临床病理特征及预后的关系。采用Cox比例风险模型对HCC患者的预后影响因素进行单因素和多因素分析。结果HCC组织中PSMA表达水平与分化程度、T分期、淋巴结转移、TNM分期、Ki-67、随访期间远处转移、BCLC分期有关(P<0.05)。单因素、多因素Cox回归分析结果显示,PSMA高表达、TNM分期Ⅲ-Ⅳ期、Ki-67≥10%、BCLC分期Ⅲ-Ⅳ期是HCC患者预后的独立危险因素(P<0.05)。Kaplan-Meier生存曲线结果显示,PSMA低表达患者5年生存率较PSMA高表达患者显著延长,差异有统计学意义(P<0.05)。结论PSMA高表达不利于HCC患者的预后,其或可作为HCC的预后指标和血管治疗靶点。

Objective To investigate the relationship between the expression of prostate-specific membrane anti-gen(PSMA)and the clinicopathological features and prognosis of hepatocellular carcinoma(HCC).Methods The clini-cal data of 100 HCC patients admitted to the Haikou Affiliated Hospital of Central South University Xiangya School of Med-icine between Jan.2014 and Dec.2015 were analyzed retrospectively.The expressions of PSMA and CD31 were detected by immunohistochemistry staining(IHC).According to the expression level of PSMA,the patients were divided into the low PSMA expression group(n=72)and high PSMA expression group(n=28).The relationship of the expression level of PSMA with the clinicopathological features and prognosis was analyzed.Cox proportional risk model was used to analyze the prog-nostic factors of HCC patients.Results The expression level of PSMA in HCC was related to the differentiation degree,T stage,lymph node metastasis,TNM stage,Ki-67,distant metastasis during follow-up and BCLC stage(P<0.05).Univariate and multivariate Cox regression analysis showed that the highly-expressed PSMA,TNM stageⅢ-Ⅳ,Ki-67≥10%,and BCLC stageⅢ-Ⅳwere independent risk factors for prognosis of HCC patients(P<0.05).The results of Kaplan-Meier sur-vival curve showed that the 5-year survival rate of patients with lowly-expressed PSMA in HCC was significantly higher 2than that of patients with highly-expressed PSMA(P<0.05).Conclusion The highly-expressed PSMA is not conducive to the prognosis of patients with HCC.PSMA may be a new prognostic index and target of vascular therapy for HCC patients.