组织中IL-26表达水平对原发性肝细胞癌肝切除患者预后的预测价值

Predictive value of IL-26 expression level in the tissues for the prognosis of hepatocellular carcinoma patients after hepatectomy

目的探讨组织中白细胞介素-26(IL-26)表达水平对原发性肝细胞癌(HCC)肝切除患者预后的预测价值。方法回顾性分析2011年1月—2014年12月中南大学湘雅医学院附属海口医院行肝切除术的120例HCC患者的临床资料。采用免疫组织化学染色(IHC)方法检测患者癌组织中IL-26的表达,根据IL-26表达水平将患者分为IL-26低表达组(n=62)和IL-26高表达组(n=58)。分析IL-26表达水平与HCC患者临床病理特征及预后的关系;采用Cox比例风险模型对HCC患者术后预后的影响因素进行单因素、多因素分析。结果HCC患者组织中IL-26表达水平与肿瘤直径>5 cm、微血管侵犯、TNMⅢ-Ⅳ期有关(χ^(2)=11.100,P=0.001;χ^(2)=11.257,P=0.001;χ^(2)=6.541,P=0.011)。单因素Cox回归分析结果显示,IL-26高表达、AFP>50μg·L^(-1)、肿瘤直径>5 cm、大血管侵犯、微血管侵犯与HCC患者无复发生存时间(RFS)和总体生存时间(OS)有关(P<0.05);多因素Cox回归分析结果显示,IL-26高表达、肿瘤直径>5 cm、微血管侵犯是HCC患者RFS的独立危险因素(P<0.05),IL-26高表达、微血管侵犯是HCC患者OS的独立危险因素(P<0.05)。Kaplan-Meier法生存曲线显示,IL-26低表达组患者5年RFS和OS高于IL-26高表达组,差异均有统计学意义(χ^(2)=11.002,P=0.001;χ^(2)=8.832,P=0.007)。结论组织中IL-26高表达的HCC术后患者预后较差,IL-26或许可作为HCC患者一种新的预后指标和抗血管治疗靶点。

Objective To investigate the prognostic value of the interleukin-26(IL-26)expression in tissues of hepato-cellular carcinoma(HCC)patients after hepatectomy.Methods The clinical data were analyzed retrospectively of 120 HCC patients who were admitted to the Haikou Affiliated Hospital of Xiangya School of Medicine,Central South University be-tween Jan 2011 and Dec 2014.The expression of IL-26 was detected by immunohistochemical staining.According to the expression levels of IL-26,the patients were divided into IL-26 low expression group(n=62)and IL-26 high expression group(n=58).The relationship between the expression level of IL-26 and the clinicopathological characteristics and prog-nosis was analyzed.Cox proportional risk model was used to analyze the prognostic factors of HCC patients.Results The ex-pression of IL-26 in HCC was correlated with the tumor diameter>5 cm,microvascular invasion and TNM stageⅢ-Ⅳ(χ^(2)=11.100,P=0.001;χ^(2)=11.257,P=0.001;χ^(2)=6.541,P=0.011).Univariate Cox regression analysis showed that high expres-sion of IL-26,AFP>50 ug/L,tumor diameter>5 cm,macrovascular invasion and microvascular invasion were associated with the recurrence-free survival(RFS)and overall survival(OS)of HCC patients.Multivariate Cox regression analysis showed that high expression of IL-26,tumor diameter>5 cm and microvascular invasion were independent risk factors of RFS in HCC patients(P<0.05),and that high expression of IL-26 and microvascular invasion were independent risk factors of OS in HCC patients(P<0.05).Kaplan-Meier survival curve showed that the 5-year RFS and OS of patients with low IL-26 expression were higher than those of patients with high IL-26 expression(χ^(2)=11.002,P=0.001;χ^(2)=8.832,P=0.007).Conclusion The prognosis was poor in HCC patients with high expression of IL-26.The expression level of IL-26 in tissues may be a new prognostic indicator and a target for vascular therapy in HCC patients.