肝硬化患者检测p21、IGF-Ⅱ及PCNA的意义

Expression of ras oncogene p21 product, IGF-Ⅱ and proliferating cell nuclear antigen in liver cirrhosis and the correlation with liver cell dysplasia

探讨p2 1、IGF -Ⅱ、PCNA的相互关系及它们在肝硬化、肝细胞不典型增生 (LCD)、肝细胞癌 (HCC)形成中的作用。用S -P法对 5 0例单纯肝硬化、2 8例癌旁肝硬化及 2 2例HCC的p2 1、IGF -Ⅱ、PCNA表达情况进行检测。癌旁肝硬化、单纯肝硬化、HCC中p2 1阳性率分别为 92 86 %、6 8%、5 4 5 5 % ;IGF -Ⅱ阳性率分别为 75 %、74 %、36 36 %。肝硬化与HCC之间差别有显著性意义 (P <0 0 5 )。伴LCD改变或HBsAg阳性的肝硬化 ,P2 1、IGF -Ⅱ、PC NA阳性表达率均高于不伴LCD改变或HBsAg阴性的肝硬化组织 (P <0 0 5 )。PCNA阳性及IGF -Ⅱ阳性的肝硬化组织 ,其p2 1阳性表达率均高于PCNA阴性及IGF -Ⅱ阴性的肝硬化组织 (P <0 0 1)。 (1)HBV感染与p2 1、IGF -Ⅱ、PCNA表达密切相关 ,它们在致肝细胞癌变过程中可能具有协同作用。 (2 )LCD是一群具有肿瘤增殖潜能的癌前细胞群 ,尤其是伴HBV感染且P2 1、IGF -Ⅱ、PCNA共同过量表达者 。

To probe the role of ras oncogene p21 product, IGF-Ⅱ and proliferating cell nuclear antigen (PCNA) in the development of cirrhotic nodules, liver cell dysplasia and hepatocellular carcinoma (HCC). S-P immunohistochemical technique was used to analyze the expression of p21, IGF-Ⅱ, PCNA and HBsAg in 50 cases of liver cirrhosis without HCC, 28 cases of paracancerous liver cirrhotic tissues, and 22 HCC cases. The positive rates for p21 in cirrhosis with or without HCC, and HCC tissue were 92 86%, 68%, 54 55%, respectively. The positive rates for IGF-Ⅱ in cirrhosis with or without HCC, and HCC tissue were 75%, 74%, 36 36%, respectively. The positive rates for p21, IGF-Ⅱ and PCNA in cirrhotic nodules with LCD or with HBsAg infection which were significantly higher than those without LCD or without HBsAg infection ( P <0 05). The incidence of p21 expression in hepatocytes was significantly higher in IGF-Ⅱ and PCNA in positive cases than in negative ones ( P <0 01). The expression levels of p21, IGF-Ⅱ and PCNA in liver cirrhosis are related to HBV infection. They may play a synergetic role in transforming liver cells into cancer. LCD are precancerous cells which have the ability to initiate neoplastic growth and present a high risk of development of HCC, especially when it was combined with HBV infection and the overexpressions of p21, IGF-Ⅱ and PCNA.