纽约食管鳞状上皮癌抗原1在原发性肝细胞肝癌组织中的表达及其临床意义

Expression of New York esophageal squamous cell carcinoma 1 in hepatocellular carcinoma and its clinical significance

目的探讨纽约食管鳞状上皮癌抗原1(NY-ESO-1)在原发性肝细胞肝癌(HCC)组织中的表达及其临床意义,以期为临床治疗该疾病提供参考依据。方法回顾性分析2013年1月至2019年12月于安徽医科大学安庆医学中心接受手术治疗的71例HCC患者的临床资料,并搜集其术后石蜡包埋的肝癌组织与癌旁组织标本,分别作为HCC组、癌旁组;同期回顾性分析30例肝血管瘤或肝内胆管结石患者的临床资料,并取其术后石蜡包埋的正常肝组织标本,作为正常组。采用免疫组织化学染色法检测3组患者组织中NY-ESO-1蛋白表达情况;分析NY-ESO-1蛋白表达与HCC患者临床病理特征的关系;使用Cox比例风险回归模型分析HCC患者预后的危险因素。结果HCC组NY-ESO-1蛋白表达阳性率显著高于癌旁组、正常组;NY-ESO-1蛋白阳性表达患者中肿瘤直径≥5 cm、Ⅱa~Ⅱb分期、Edmondson分级Ⅲ/Ⅳ级、Ki-67高表达、微血管侵犯(MVI)为M1/2级患者占比均显著高于NY-ESO-1蛋白阴性表达患者;NY-ESO-1蛋白表达阳性患者的总存活率显著低于NY-ESO-1蛋白表达阴性患者;Cox比例风险回归模型单因素和多因素分析结果显示,肿瘤直径≥5 cm、Ⅱa~Ⅱb分期、Edmondson分级Ⅲ/Ⅳ级、Ki-67高表达、MVI为M1/2级、NY-ESO-1阳性均是影响HCC患者预后的危险因素(HR=4.106、2.184、5.579、13.967、3.296、2.735)(均P<0.05)。结论NY-ESO-1在HCC组织中呈高表达,且肿瘤直径≥5 cm、Ⅱa~Ⅱb分期、Edmondson分级Ⅲ/Ⅳ级、Ki-67高表达、MVI M1/2级、NY-ESO-1阳性均是影响HCC患者预后的危险因素,临床上可针对上述因素采取相应措施,改善患者预后。

Objective To investigate the expression of New York esophageal squamous cell carcinoma 1(NY-ESO-1)in hepatocellular carcinoma(HCC)tissues and its clinical significance,in order to provide reference for clinical treatment of this disease.Methods The clinical datas of 71 patients with HCC underwent surgical treatment admitted to Anqing Medical Center of Anhui Medical University from January 2013 to December 2019 were retrospectively analyzed,the paraffin-embedded liver cancer tissue and paracancer tissue samples were collected after surgery,as the HCC group and the paracancer group respectively;the clinical datas of 30 patients with hepatic hemangioma or intrahepatic bile duct calculus were retrospectively analyzed,the paraffin-embedded normal liver tissue samples were collected after surgery,as the normal group.The expression of NY-ESO-1 protein in the three groups were detected by immunohistochemical staining;the relationship between NY-ESO-1 protein expression and clinicopathologic features of HCC patients were analyzed;the risk factors of the prognosis of HCC patients were analysed by Cox proportional risk regression model.Results The positive expression rate of NY-ESO-1 protein in the HCC group was significantly higher than that in the paracancer group and the normal group;the proportion of patients with tumor diameter≥5 cm,Ⅱa~Ⅱb stage,Edmondson gradeⅢ/Ⅳgrade,Ki-67 high expression,microvascular invasion(MVI)grade M1/2 grade in patients with NY-ESO-1 protein positive expression were significantly higher than that in patients with NY-ESO-1 protein negative expression;the overall survival rate of patients with NY-ESO-1 protein positive expression was significantly lower than that of patients with NY-ESO-1 protein negative expression;the results of univariate and multivariate analysis of Cox proportional risk regression model showed that,tumor diameter≥5 cm,Ⅱa~Ⅱb stage,Edmondson gradeⅢ/Ⅳgrade,Ki-67 high expression,MVI grade M1/2 grade,and NY-ESO-1 positive expression were all the risk factors for the prognosis of HCC patients(HR=4.106,2.184,5.579,13.967,3.296,2.735)(all P<0.05).Conclusion NY-ESO-1 is highly expressed in HCC tissues,and the tumor diameter≥5 cm,Ⅱa~Ⅱb stage,Edmondson gradeⅢ/Ⅳgrade,Ki-67 high expression,MVI grade M1/2 grade,and NY-ESO-1 positive expression are all the risk factors for the prognosis of HCC patients.In clinic,the corresponding measures can be taken according to the above factors,in order to improve HCC patients’outcomes.