癌旁组织ALOX15表达与肝癌根治性切除术后预后的关系

Relationship between ALOX15 expression in adjacent tissues and prognosis of hepatocellular carcinoma patients after radical resection

目的探讨癌旁组织花生四烯酸15-脂氧合酶(ALOX15)表达与肝细胞癌(肝癌)患者根治性切除术后预后的关系。方法回顾性分析2013年1月至2016年12月在重庆医科大学附属第一医院接受根治性切除手术的306例肝癌患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男259例,女47例;年龄10~79岁,中位年龄52岁。采用免疫组化法检测癌旁肝组织ALOX15表达并进行染色评分,根据ALOX15表达量的最佳界值将患者分为ALOX15低表达组(222例)和ALOX15高表达组(84例)。生存分析采用Kaplan-Meier法和Log-rank检验。肝癌患者预后影响因素分析采用Cox比例风险回归模型。结果癌旁组织ALOX15染色主要在细胞质和细胞膜,阳性细胞主要分布在肝细胞间质。癌旁组织ALOX15高表达组22例,ALOX15高表达组84例。ALOX15低表达组患者术后1、3、5年总体生存率分别为91.8%、83.0%、77.6%,无瘤生存率分别为83.7%、67.3%、60.9%;ALOX15高表达组术后1、3、5年总体生存率分别为90.9%、54.5%、44.5%,无瘤生存率分别为65.5%、40.3%、22.9%;ALOX15低表达组术后总体生存及无瘤生存均明显优于ALOX15高表达组(χ^(2)=32.223,36.408;P<0.05)。多因素Cox分析显示,ALOX15染色评分>27分是患者术后总体生存和无瘤生存的独立危险因素(HR=2.986,2.350;P<0.05)。结论癌旁组织ALOX15高表达是肝癌根治性切除术后预后的独立危险因素,高表达患者生存预后差,术后容易复发。

Objective To investigate the relationship between the expression of arachidonic acid 15-lipoxygenase(ALOX15)in adjacent tissues and clinical prognosis of patients with hepatocellular carcinoma(HCC)after radical resection.Methods Clinical data of 306 patients with HCC who underwent radical resection in the First Affiliated Hospital of Chongqing Medical University from January 2013 to December 2016 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,259 patients were male and 47 female,aged from 10 to 79 years,with a median age of 52 years.The expression level of ALOX15 in adjacent tissues was determined by immunohistochemical staining and the degree of staining was scored.According to the optimumcut-off value of ALOX15 expression level,all patients were divided into the low(n=222)and high expression groups(n=84).Survival analysis was conducted by Kaplan-Meier method and Log-rank test.The prognostic factors of HCC patients were identified by Cox proportional hazard regression model.Results ALOX15 staining was mainly observed in cytoplasm and cell membrane of adjacent tissues,and positive cells were primarily distributed in hepatocyte stroma.There were 22 cases with high expression of ALOX15 in adjacent tissues and 84 cases with high expression of ALOX15.The postoperative 1-,3-and 5-year overall survival rates of patients with low expression of ALOX15 were 91.8%,83.0%and 77.6%,and 83.7%,67.3%and 60.9%for the tumor-free survival rates,respectively.The postoperative 1-,3-and 5-year overall survival rates of those with high expression of ALOX15 were 90.9%,54.5%and 44.5%,and 65.5%,40.3%and 22.9%for the tumor-free survival rates,respectively.The postoperative overall survival and tumor-free survival in the low ALOX15 expression group were significantly better than those in the high ALOX15 expression group(χ^(2)=32.223,36.408;P<0.05).Multivariate Cox analysis showed that the immunoreactive score of ALOX15>27 was an independent risk factor for postoperative overall survival and tumor-free survival(HR=2.986,2.350;P<0.05).Conclusions High expression of ALOX15 in adjacent tissues is an independent risk factor for clinical prognosis of HCC patients after radical resection.Patients with high expression of ALOX15 obtain poor prognosis and are prone to postoperative recurrence.