Evaluation for clinical utility of GPC3, measured by a commercially available ELISA kit with Glypican‐3 (GPC3) antibody,as a serological and histological marker for hepatocellular carcinoma

Aims: We evaluated the clinical utility of glypican‐3 (GPC3), which has been proposed as a potential novel tumor marker for hepatocellular carcinoma (HCC), as a serological and histological marker for HCC. Methods: The serum GPC3 level was compared between 200 patients with HCC and 200 patients with chronic liver disease (CLD). In addition, the expression of GPC3 was examined with immunohistochemistry on 38 resected specimens from patients with HCC. A commercially available GPC3 antibody was used for these analyses. Results: The median values of serum GPC3 in patients with HCC and with CLD were 924.8 pg/mL and 1161.6 pg/mL, respectively. We found no elevation of serum GPC3 level in patients with HCC in comparison with those with CLD; rather the level was higher in patients with CLD (P < 0.0001). In immunohistochemical analysis, 14 of 38 (36.9%) HCC tissues were positive for GPC3, whereas no corresponding non‐cancerous tissue was positive. The positivity for GPC3 tended to increase with pathologic decreased differentiation of HCC. Conclusions: We did not find serum GPC3 level, measured by a commercially available ELISA kit with GPC3 antibody, to be useful in the diagnosis of HCC. However, we did observe increased GPC3 staining in HCC tissue with moderate or poor differentiation, suggesting that GPC3 is produced by HCC tumors. This lack of utility could have been due to the measuring procedure used in the present study. Further evaluation of GPC3 in HCC with other measuring procedures is needed.     

The clinical value of hepatocyte growth factor and its receptor—c-met for liver cancer patients with hepatectomy

BACKGROUND: To study the dynamic change of hepatocyte growth factor after hepatectomy in patients with primary liver cancer, and to analyse the prognostic value of hepatocyte growth factor and c-met for these patients. METHODS: Thirty-one consecutive patients undergoing partial hepatectomy for liver cancer were studied. Serum hepatocyte growth factor level was determined by using enzyme-linked immunosorbent assay kit before and after operation, respectively. C-met protein and MRNA expressions in cancerous and paracancerous tissues were examined by immunohistochemical and RT-PCR methods, respectively. The correlations between clinical-pathologic parameters and the expressions of hepatocyte growth factor in serum and c-met in cancerous tissues were analysed, respectively. RESULTS: Liver cancer patients had a significantly higher level of serum hepatocyte growth factor than normal controls (1.0424+/-0.498 ng/ml versus 0.685+/-0.115 ng/ml, p=0.008). Serum hepatocyte growth factor level was positively affected by tumour size, node cirrhosis, portal vein tumour thrombi, cholangiocarcinoma (including combined hepatocellular carcinoma), poorly differentiated hepatocellular carcinoma and tumour recurrence or metastases. After hepatectomy, serum hepatocyte growth factor level peaked on the third postoperative day, and then declined, but did not return to normal level on the postoperative day 10. From the preoperative day to postoperative day 10, the level of serum hepatocyte growth factor had a decrease of percent (85.33+/-10.2%) in the group with large tumours (>5 cm), but an elevation of percent (121.9+/-10.3%) in the group with small tumours (相似文献   

The role of des-gamma-carboxyprothrombin expression in hepatocellular carcinoma

BACKGROUND/AIMS: Des-gamma-carboxyprothrombin (DCP), is a well-known tumor marker of hepatocellular carcinoma (HCC). On the other hand, some reports suggest that tissue expression of DCP is more useful as a prognostic factor than the serum DCP value. The aim of this study is to clarify the clinicopathological role of expression of DCP on HCC, especially when there is a low serum level of DCP. METHODOLOGY: Fifty-one patients with HCC who underwent curative hepatectomy were included in this study. Immunohistochemical staining was performed using anti-DCP monoclonal antibody, which was classified into 2 groups (strong and weak) by a pathologist. The immunohistochemical expression of tumor microvessel density (MVD) was evaluated using CD34 monoclonal antibody, and counted with specific staining of the capillary-like vessels in the tumor. The clinicopathological variables were compared between the strong and weak-staining groups. RESULTS: A strong DCP expression was recognized in 31 patients. DCP expression was associated with tumor size (p < 0.05) and portal vein infiltration (p < 0.01). In addition, serum DCP levels and alpha-fetoprotein levels tended to be higher in the strong group. In 16 patients whose serum DCP level was < 200mAU/ml, the recurrence-free survival rate was significantly lower in the strong group. No correlation was observed between DCP expression and MVD. CONCLUSIONS: DCP expression in HCC is useful for the prediction of early recurrence in patients with a low serum DCP level.     

慢性肝病患者肝组织中HGV抗原的表达及意义

目的探讨慢性肝病患者组织中庚型肝炎病毒（ＨＧＶ）表达与意义。方法应用免疫组织化学方法以鼠抗ＨＧＶＮＳ５甲克隆抗体检测１４２例慢性肝病患者肝组织中ＨＧＶ抗原，部分患者采用ＲＴ－ＰＣＲ方法检测其血清中ＨＣＶＲＮＡ。结果１４２例肝病患者中，２９例（２０．４％）组织中检出ＨＧＶ抗原，肝硬化组（４２．９％，１２／２８）较慢性肝炎（１５．９％８／１１）和肝癌（１４．３％，９／６３）组检出率高。阳性信号位于胞浆中，阳性细胞可成散在、簇状或弥漫性分布。阳性细胞周围可有炎性坏死；肝癌患者抗原阳性细胞主要位于癌旁肝组织，癌巢中仅偶见少数散在分布的阳必细胞；绝大多数组织抗原阳性者其血清ＨＧＶＲＮＡ为阳性。有４例患者组织中ＨＧＶ抗原阳性但其血清ＨＧＶＲＮＡ阴性。结论ＨＧＶ可在慢性肝病包括肝细胞肝癌患者肝组织中表达，ＨＧＶ感染在慢性肝炎病期进展及肝癌发生中具有一定意义。     

肝细胞癌癌组织caspase-3和DcR3蛋白及SNHG12 mRNA水平变化及其临床意义探讨*

目的 研究肝细胞癌(HCC)患者癌组织半胱氨酰天冬氨酸特异性蛋白酶-3(caspase-3)和诱捕受体3(DcR3)蛋白表达及小分子核仁宿主基因12(SNHG12)mRNA水平变化及其临床意义。方法 2016年5月～2019年5月我院收治的68例HCC患者,行肝叶切除术治疗,取癌组织和癌旁肝组织,采用EnVision法检测caspase-3和DcR3蛋白表达,采用RT-qPCR法检测SNHG12 mRNA水平,应用Logistic多元回归分析影响HCC患者死亡的危险因素。结果 HCC患者癌组织caspase-3阳性率为47.1%,显著低于癌旁组织的77.9%(P＜0.05),而DcR3阳性率为61.8%,SNHG12 mRNA水平为(2.9±0.8),显著高于癌旁组织【分别为33.8%和(1.6±0.5),P＜0.05】;18例有淋巴结转移的癌组织caspase-3阳性率为33.3%,显著低于50例无淋巴结转移者的62.0%(P＜0.05),而DcR3蛋白阳性率为88.9%,显著高于无淋巴结转移者的50.0%,SNHG12 mRNA水平为(2.6±0.4),显著高于无淋巴结转移者【(1.5±0.3),P＜0.05】,45例肿瘤直径>5 cm癌组织SNHG12 mRNA水平为(2.7±0.4),显著高于23例无淋巴结转移者【(1.4±0.3),P＜0.05】;随访结束时,本组68例HCC患者生存30例(44.1%),死亡38例(55.9%);多元Logistic回归分析显示,肿瘤直径大、合并肝硬化、存在淋巴结转移、Caspase-3低表达、DcR3高表达和SNHG12高水平是HCC患者死亡的危险因素。结论 HCC患者癌组织存在基因水平和蛋白表达的显著变化,了解这些变化并探讨其临床意义,将为肝癌防治提供有价值的线索。     

Des-gamma-carboxyprothrombin, alpha-fetoprotein and AFP-L3 in patients with chronic hepatitis, cirrhosis and hepatocellular carcinoma

Background and Aim: Hepatocellular carcinoma (HCC) is a common complication in patients with chronic viral hepatitis. Detection of HCC at an early stage is critical for a favorable clinical outcome. The study aim was to: (i) compare the levels of des‐γ‐carboxyprothrombin (DCP), α‐fetoprotein (AFP) and AFP‐L3 in HCC patients and in chronic viral hepatitis patients without HCC; (ii) define the level of each tumor marker with the best sensitivity and specificity for HCC diagnosis; and (iii) to correlate the levels of these markers with respect to size and tumor burden. Methods: Two hundred and forty patients with either hepatitis B virus (HBV) or hepatitis C virus (HCV) infection were studied. These included 144 with HCC, 47 with chronic hepatitis (fibrosis stage I–III on liver biopsy) and 49 with cirrhosis. Results: Levels of DCP, AFP and AFP L‐3 were significantly higher in patients with HCC than in those without HCC (P ≤ 0.0001). Receiver–operating curves (ROC) indicated that the cut‐off value with the best sensitivity and specificity for each test was ≥84 mAU/mL for DCP, ≥25 ng/mL for AFP and ≥10% for AFP‐L3. The sensitivity, specificity and positive predictive value (PPV) for DCP was 87%, 85% and 86.8%, for AFP 69%, 87% and 69.8%, and for AFP‐L3 56%, 90% and 56.1%, respectively. DCP levels were below the ROC cut‐off in all patients without HCC. In patients with single lesions, there was a direct correlation of DCP to tumor size. High levels of AFP correlated with diffuse type of HCC. All three markers were significantly elevated in the presence of metastatic HCC. No advantage was observed by combining two or three markers for HCC diagnosis. Conclusion: DCP had the highest sensitivity and PPV for HCC diagnosis, had a direct correlation with tumor size, and was not elevated in any patients without HCC. DCP should be used as the main serum test for HCC detection.     

Pathological observations of sinusoid lining endothelial cells and the basement membrane in human hepatocellular carcinoma

OBJECTIVE : To observe changes in sinusoid lining endothelial cells (SEC), type IV collagen (CoIV) and laminin (LM) in chronic liver disease and hepatocellular carcinoma (HCC). To assess the clinicopathological significance of these changes in HCC. METHODS : Thirty specimens were taken from 30 cases of HCC (together with corresponding non‐cancerous tissues), 10 cases of liver cirrhosis, five cases of mild chronic hepatitis and and four cases of normal liver tissues. The specimens were tested for CD34, CoIV and LM by using immunohistochemical methods. CD34, CoIV and LM were semiquantitatively analyzed and assessed in the context of the clinical and pathological features of HCC. RESULTS : CD34 and LM were not present along the sinusoidal walls in normal human liver, however, CoIV was weakly and discontinuously distributed along the sinusoidal walls. In cirrhosis, positive expression of CoIV increased significantly in the sinusoidal walls and became continuous and homogeneous. CD34 and LM were weakly present in the perinodules in a few cases of cirrhosis with obvious inflammatory infiltration. Hepatocellular carcinoma showed a diffuse capillarization, with overexpression of CD34, CoIV and LM. CoIV and LM expression were reduced in poorly differentiated HCC and HCC with portal vein thrombosis. This was frequently accompanied by breaks and losses in the basement membrane. The expression of CD34 in tumors of < 2 cm in diameter was significantly lower than that in tumors of > 5 cm in diameter. The expression of CD34 and LM was markedly increased in HCC compared with non‐cancerous liver tissues. CONCLUSIONS : Diffuse capillarization with overexpression of CD34, CoIV and LM are features of HCC. Frequent breaks in, loss of and decrease of the basement membrane in poorly differentiated tumors and tumors with portal vein infiltration suggests potential metastasis of tumor cells and may play a major role in the metastasis of HCC. CD34 is a useful marker for distinguishing HCC from non‐cancerous liver tissues.     

肝细胞肝癌癌组织及癌旁肝组织中HCVNS5蛋白的检测

为了解肝细胞肝癌（ＨＣＣ）患者丙型肝炎病毒（ＨＣＶ）感染状况，应用免疫组织化学方法以单克隆鼠抗－ＨＣＶＮＳ５检测了一组ＨＣＣ患者癌组织和癌旁肝组织中ＨＣＶ表达情况。结果：６４例ＨＣＣ患者癌旁肝组织中，共检出ＨＣＶＮＳ５阳性３０例（４６．９），阳性信号位于癌细胞和癌直细胞胞浆中，阳性细胞多呈弥漫或簇状分布；３０例ＨＣＶＮＳ５呈阳性的标本中，７例只于癌直细胞中检出，１２例只存在于癌组织中，另１１例癌旁     

Diagnostic accuracy of α-fetoprotein and des-γ-carboxy prothrombin in screening for hepatocellular carcinoma in liver transplant candidates

Aim: Although hepatocellular carcinoma (HCC)‐specific serum tumor markers, α‐fetoprotein (AFP) and des‐γ‐carboxy prothrombin (DCP), are used in the screening for HCC, their utility in pre‐transplantation evaluation is not well established. This study aimed to evaluate the accuracy of AFP and DCP measurement for the diagnosis of HCC in liver transplant candidates. Methods: A total of 315 consecutive adult patients (174 men and 141 women, mean age 52 years), who were to receive liver transplantation for end‐stage liver diseases, were enrolled. The pre‐transplant levels of AFP and DCP were compared with the histopathology of explanted liver. Results: Hepatocellular carcinoma was present in the explanted liver of 106 recipients (median number of nodules 2, mean diameter 2.5 cm). The area under receiver operating characteristic curve for the diagnosis of HCC was 0.83 (95% confidence interval, 0.78–0.88) for AFP and 0.47 (0.41–0.54) for DCP. With the cut‐off value of 100 mAU/mL, 20/106 (18.9%) patients with HCC and 54/194 (27.8%) patients without HCC were positive for DCP. DCP positivity was associated with vascular invasion, tumor differentiation and size among patients with HCC, which was associated with albumin level among patients without HCC. Vitamin K was administered prior to transplantation to 20 patients who were positive for DCP (two with and 18 without HCC), resulting in a decrease in DCP levels in 19 of them. Conclusions: Serum DCP levels may be raised in end‐stage liver disease patients without HCC, and cannot be used as a reliable marker for HCC among liver transplant candidates.     

抑癌基因PTEN在原发性肝癌中的表达及意义

目的 研究抑癌基因PTEN在原发性肝癌发生过程中的作用及意义。方法 应用免疫组织化学和northern杂交分析60例原发性肝癌及对应癌旁组织中PTEN mRNA及PTEN蛋白表达情况,结合患者的临床病理资料分析PTEN在原发性肝肝癌中的意义。结果 PTEN蛋白明确定位于肝细胞胞浆内。60例HCC的癌组织中,PTEN蛋白阳性率为48.3％(29/60),明显低于癌旁肝组织的阳性率(100％)。PTEN蛋白在肝癌组织内的表达阳性率与肝癌的病理学分级、有无癌栓有关,PTEN蛋白在肝癌组织的Ⅰ～Ⅱ级、Ⅲ级、Ⅳ级的阳性率分别为84.0％、23.8％、21.4％,无癌栓形成组PTEN蛋白表达的阳性率为55.56%,有癌栓形成组PTEN蛋白表达的阳性率为26.7％。Northern杂交显示,PIEN基因在肝癌细胞内存在四个转录子,其大小分别为5.5、4.4、2.4、1.8 kb。患者肝癌组织内PTEN mRNA的表达水平明显低于对应的癌旁肝组织。PTEN 5.5 kb和4.4 kb的转录子表达水平的降低与血清中AFP水平、有无癌栓、有无卫星灶及病理学分级有关;2.4 kb的转录子表达水平降低与患者有无癌栓、有无卫星灶有关;1.8 kb转录子表达水平的降低与临床病理学指标无关。结论 PTEN在肝癌的发生过程中可能起重要作用,其表达水平有可能作为反映肝癌进展和预后的病理学指标。     

Expression of 8‐hydroxy‐2′‐deoxyguanosine in chronic liver disease and hepatocellular carcinoma

Abstract: Reactive oxygen species may be involved in the progression of chronic liver disease and the occurrence of hepatocellular carcinoma (HCC). To clarify whether clinicopathological findings in liver diseases are related to oxidative DNA damage, hepatic expression of the 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG) was examined in 75 liver disease patients, which included 32 chronic hepatitis (CH), 13 liver cirrhosis (LC) and 30 HCC patients. The CH patients had higher 8‐OHdG‐positive hepatocytes than LC (P<0.05). In CH and LC, the number of 8‐OHdG‐positive hepatocytes was correlated with alanine aminotransferase and asparate aminotransferase (P<0.01 and P<0.05, respectively). Of 30 HCC cases, 25 cases (83%) showed stronger immunoreactivity than non‐cancerous counterparts. The patients with poorly differentiated HCC had a larger tumor size and higher levels of AFP, and exhibited higher labeling indices of PCNA‐, TUNEL‐ and 8‐OHdG‐positive cells than those with well and moderately differentiated HCC. Our findings suggest that oxidative DNA damage is increased in association with necroinflammation in chronic liver disease and determination of 8‐OHdG is useful in assessing high‐grade malignancy in HCC.     

Expression and significance of new inhibitor of apoptosis protein survivin in hepatocellular carcinoma

AM: To investigate expression and significance of inhibitor of apoptosis protein survivin in hepatocellular carcinoma (HCC). METHODS: The expression of survivin and vascular endothelial growth factor (VEGF) was investigated in 38 cases of HCC tissues and 38 liver cirrhosis tissues by immunohistochemistry and Western blot. The relationship between the expression of survivin and clinicopathological factors of HCC was analyzed. RESULTS: Survivin protein was detected in 23 (60.5%) of 38 HCCs and 3 (7.9%) of 38 liver cirrhosis tissues. In 23 cases of HCC which expressed survivin, the expression of VEGF was positive in 18 cases and slight positive or negative in 5 cases. While in 15 cases of HCC which did not express survivin, 12 cases did not express or slightly expressed, and 3 cases expressed VEGF. In liver cirrhosis tissues, the expression of VEGF was as follows: 24 cases were negative, 10 cases were weak positive and 4 cases were strong positive. The expression of survivin was coincident with the expression of VEGF in HCC (P<0.01). The expression of survivin in HCC had no relationship with the patients' age, gender, tumor size and differentiation level of HCC, while it was related to the metastasis of HCC. The protein quantitative analysis by Western blot also showed that overexpression of survivin in HCC was closely correlated to the expression of VEGF (P<0.01). Furthermore, stronger expression of survivin and VEGF was also found in patients with metastasis rather than in those with no metastasis (P<0.01). CONCLUSION: Survivin plays a pivotal role in the metastasis of HCC, and it has some correlation with tumorigenesis. The expression of survivin in the primary lesion is very useful as an indicator for metastasis and prognosis of HCC. It could become a new target of gene therapy of HCC.     

基于多数据库分析肝细胞癌组织FAM49B基因水平及其临床意义

目的 利用多数据库分析肝细胞癌(HCC)组织FAM49B基因水平及其临床意义。方法 利用Oncomine和GEPIA数据库分析HCC组织与正常肝组织FAM49B基因水平,从TCGA获取临床病例资料,应用SPSS 21.0软件统计分析不同临床和病理学特征的HCC组织FAM49B基因水平的异同。自Kaplan Meier Plotter数据库分析不同FAM49B基因水平的HCC患者预后的异同,自MethHC数据库分析FAM49B启动子区甲基化水平,利用String数据库分析与FAM49B相互作用的蛋白网络,采用基因集富集分析(GSEA)预测FAM49B在HCC发病过程中可能的信号调控通路。结果 对Oncomine和GEPIA数据库分析显示HCC组织FAM49B基因水平显著高于正常肝组织(P均<0.01);不同性别(P=0.001)、有无肝硬化(P=0.003)、不同肿瘤分化程度(P=0.004)的HCC组织FAM49B基因水平显著不同,而不同年龄、肿瘤大小、病理学分期、甲胎蛋白水平和有无脉管侵犯者无显著性差异(P均>0.05);与FAM49B低水平患者比,FAM49B高水平患者总体生存期显著缩短,具有统计学意义(HR=1.8,P=0.0012);与正常肝组织相比,HCC组织FAM49B启动子区甲基化水平显著降低(P＜0.005);与FAM49B相互作用的蛋白有SERPINA1、ISLR和FERMT3;在FAM49B mRNA高水平组织富集到细胞凋亡、细胞周期、调节自噬和P53信号通路等相关基因集(P均<0.05)。结论 FAM49B在HCC组织呈高水平,其基因水平与HCC恶性程度和患者不良预后相关,可能作为癌基因在HCC发生发展过程中发挥作用,有望成为HCC诊断及预后评估的新靶点。     

Immunohistochemical detection of HCV infection in patients with hepatocellular carcinoma and other liver diseases

ＩｍｍｕｎｏｈｉｓｔｏｃｈｅｍｉｃａｌｄｅｔｅｃｔｉｏｎｏｆＨＣＶｉｎｆｅｃｔｉｏｎｉｎｐａｔｉｅｎｔｓｗｉｔｈｈｅｐａｔｏｃｅｌｕｌａｒｃａｒｃｉｎｏｍａａｎｄｏｔｈｅｒｌｉｖｅｒｄｉｓｅａｓｅｓＺＨＡＮＧＬｉＦａ１,ＰＥＮＧＷｅｎＷｅｉ２,...     

肝细胞癌癌组织CBX7和PERK表达及其对手术治疗后患者预后的影响*

目的 研究肝细胞癌癌组织色素框同源蛋白7(CBX7)和磷酸化胞外信号调节激酶(PERK)表达及其对术后预后的影响。方法 2016年1月～2017年1月在我院接受治疗的肝细胞癌患者68例,所有患者接受肝癌切除术,并随访3年。术后,取癌组织和癌旁肝组织,采用RT-PCR法检测癌组织和癌旁组织CBX7 mRNA和PERK mRNA水平,采用免疫组化法检测癌组织CBX7和PERK蛋白表达。结果 癌组织CBX7 mRNA水平为(0.51±0.10),显著低于癌旁组织【(4.11±0.91),P<0.05】,而癌组织PERK mRNA水平为(4.87±0.99),显著高于癌旁组织【(0.58±0.15,P<0.05】;38例肿瘤直径>3 cm患者癌组织CBX7蛋白呈高表达阳性率为33.3%,显著低于30例肿瘤直径≤3 cm组的66.7%,而PERK高表达阳性率为73.3%,显著高于肿瘤直径≤3 cm组的26.7%,28例AJCC Ⅲ/Ⅳ期患者癌组织CBX7蛋白呈高表达阳性率为8.3%,显著低于40例AJCC Ⅰ/Ⅱ期患者的91.7%,而PERK高表达阳性率为70.0%,显著高于对照组的30.0%(P<0.05);32例癌组织CBX7高表达患者1 a、2 a和3 a生存率分别为78.1%、65.6%和53.1%,显著高于36例呈低表达患者【分别为52.7%、38.9%和30.6%,P<0.05】,38例癌组织PERK高表达患者1 a、2 a和3 a生存率分别为55.3%、44.7%和31.6%,显著低于30例呈低表达患者【分别为80.0%、63.6%和53.3%,P<0.05】。结论 癌组织CBX7表达下调,而PERK表达增强的HCC患者预后差,需要给予特别的关注。     

Clinical Significance of Abnormal Prothrombin (DCP) in Relation to Postoperative Survival and Prognosis in Patients with Hepatocellular Carcinoma

Objectives: In this study we correlate plasma des-y-carboxy prothrombin (DCP) levels with prognosis in patients with hepatocellular carcinoma (HCC) in combination with serum a-fetoprotein levels (AFP). Methods: Levels of DCP were measured in 165 patients with HCC by an enzyme immunoassay (EIA, E-1023) with an anti-DCP monoclonal antibody. Results: There was no correlation between the plasma DCP levels and the serum AFP levels. The positive rate obtained from the combination assay was 72.1%. The survival rates of the patients with elevated levels of both DCP and AFP were significantly lower than those of the groups with normal DCP and AFP levels ( P < 0.05). The disease-free survival rates of patients with elevated DCP and AFP levels were also significantly lower than those of patients with normal DCP and AFP levels ( P < 0.05). The recurrence rate within a postoperative period of 2 yr was higher in the patients with elevated DCP and AFP levels than in those with normal levels. Conclusions: The determination of plasma DCP levels combined with AFP levels appears to be useful for the diagnosis and prognosis of HCC, and is useful also in postoperative monitoring for recurrence.     

肝细胞癌组织中信号素3F 蛋白表达变化及其与患者预后的关系

目的：探讨肝细胞癌（HCC）组织中信号素3F（SEMA3F）蛋白表达与患者预后的关系。方法采用Western blot法检测32例HCC患者手术切除的HCC组织（ HCC组）和相应癌旁肝组织（对照组）标本中的SEMA3F蛋白表达,分析SEMA3F蛋白表达水平与HCC临床病理特征、复发转移及预后的关系。结果 HCC组及对照组SEMA3F蛋白表达阳性率分别为84％、97％,HCC组SEMA3F蛋白表达量低于对照组（P＜0．05）。肿瘤有包膜者SEMA3F蛋白表达量高于无包膜者,肿瘤为单个结节者表达量高于多个结节者（P均＜0．05）。 HCC组有、无肝硬化者的SEMA3F蛋白表达量差异无统计学意义。15例SEMA3F蛋白低表达者复发率显著高于17例高表达者,生存时间短于高表达者（P均＜0．05）。结论 SEMA3F可能在抑制HCC的侵袭转移中起重要作用。癌组织中SE-MA3F表达水平有助于判断HCC患者的预后。     

Increase of Serum Des-gamma-Carboxy Prothrombin in Alcoholic Liver Disease Without Hepatocellular Carcinoma

The purpose of this study is to determine serum des-gamma-carboxy prothrombin (DCP) levels in benign liver diseases by a new sensitive method, and to demonstrate the elevation of serum DCP in alcoholic liver disease (ALD) without hepatocellular carcinoma (HCC). Median values of serum DCP were 16.2 mAU/ml (range: 3.2 to 1570 mAU/ml) in ALD and 16.7 mAU/ml (1.2 to 75.4 mAU/ml) in viral liver disease (VLD). Using the cut-off value of 40 mAU/ml as a tumor marker for HCC, 21% (11/52) was positive in ALD and 2% (1/57) was positive in VLD ( p = 0.0014, Fisher's exact probability test), and 27% (9/33) was positive in alcoholic liver cirrhosis and 3% (1/39) was positive in viral liver cirrhosis ( p = 0.0042, Fisher's exact probability test). The positive rate of DCP was significantly ( p < 0.001, Spearman's rank correlation test) correlated with the severity of liver disease in ALD. Serum vitamin K level was not decreased in cases with ALD. In a demonstrable case, serum DCP was decreased after abstinence and was increased again after the beginning of ethanol intake, suggesting the involvement of ethanol to the elevation of serum DCP in ALD. In conclusion, serum DCP was significantly elevated in ALD, compared with VLD, although the mechanism of the elevation of DCP was not clarified. Ethanol intake may act, in part, on the increase of serum DCP in ALD.