肝细胞癌凋亡、p21和PCNA表达与临床预后关系的研究

目的：研究ＨＣＣ细胞凋亡，ｐ２１和ＰＣＮＡ表达与临床预后的关系。方法；５５例ＨＣＣ标本采用ＤＡＮ末端（Ｔｕｎｅｌ）和免疫化检测并结合计算机图像技术定量分析。结果：小肝癌ＡＩ高于大肝癌，肝内转移，浸润性及低分化ＨＣＣ的ＡＩ分别低于无转移，非浸润性及高分化ＨＣＣ。而ＰＣＮＡ－ＬＩ恰好相反。癌旁组织ｐ２１阳性率及ｐ２１表达值均高于癌组织。并且癌及癌旁组织ｐ２１表达值在浸润性及肝内转移ＨＣＣ分析高于非侵蚀

A study of correlation between apoptosis,expression of p21 protein and PCNA, and the clinical prognosis in hepatocellular carcinoma

Objective:To investigate the prognostic significance of apoptosis,expression of p21 protein and PCNA in hepatocellular carcinoma(HCC). Methods:We examined apoptosis,expression of PCNA and p21 in 55 HCCs by the in situ end labeling and immunohistochemical methods in combination with computer imaging analytic technique. Results:Apoptosis index(AI)was significantly higher in small HCCs (< 5 cm)than large HCCs (P< 0 01),and HCCs with intrahepatic metastasis,infiltration and poorly differentiation had a significantly lower AI than those without intrahepatic metastasis (P< 0 01),no infiltration and well differentiation (P< 0 05). However,PCNA LI was found in negative relation to AI on the above state (P< 0 01). The positive percentage and the expression level of p21 were significantly higher in tumor surrounding tissues than that in tumor tissues (P< 0 01),and HCCs with infiltration and intrahepatic metastasis had a significantly higher p21 expression level than those without infiltration and intrahepatic metastasis(P< 0 01). Moreover, AI was highly inversely related to PCNA LI (r=-0 7289,P< 0 001),and significantly higher in patients with long postoperative survival (over one year)than those with short survival (P< 0 01). Conclusions:AI,PCNA LI and p21 expression level in HCC were closely associated with the differentiation,infiltration,metastasis and prognosis of the tumor,and thus probably became potential markers in predicting prognosis of HCC.