miR-150-5p抑制肝癌细胞的迁移和侵袭及其机制

目的:探讨mi R-150-5p在肝细胞癌(HCC)细胞迁移与侵袭中的作用及其调控机制。方法:用荧光定量PCR测定mi R-150-5p在正常肝细胞系L02及HCC细胞系Hep G2中的表达;将Hep G2细胞分成两组,分别转染mi R-150-5p(mi R-150-5p组)与随机序列(对照组),转染后,分别用细胞划痕实验、Transwell小室基质渗透实验检测细胞的迁移和侵袭能力,用Western blot检测细胞基质金属蛋白酶2(MMP2)和基质金属蛋白酶9(MMP9)的蛋白表达。结果:mi R-150-5p的表达量在Hep G2细胞系中明显降低,为L02细胞系的0.26倍(P0.01)。转染后,mi R-150-5p组的mi R-150-5p水平明显升高,为对照组的9.53倍(P0.001);mi R-150-5p组的细胞划痕愈合率明显低于对照组(54.63%vs.87.51%,P0.01),细胞侵袭数明显少于对照组(138个vs.452个,P0.01);MMP2与MMP9蛋白表达量均明显低于对照组(0.78 vs.1.75;0.82 vs.1.85,均P0.05)。结论:mi R-150-5p在HCC细胞中表达降低,升高mi R-150-5p的表达可抑制HCC细胞的迁移和侵袭,机制可能与其下调MMP2和MMP9表达有关。     

miR-96的表达对肝细胞癌细胞迁移和侵袭的影响

目的:探讨miR-96在肝细胞癌(HCC)细胞中的表达及作用。方法:用qRT-PCR测定miR-96在不同HCC细胞系(HepG2、7721、huh7)及正常肝细胞系L02中的表达;将HepG2细胞分别转染miRNA随机序列(阴性对照组)、miR-96模拟物(miR-96模拟物组)和miR-96抑制物(miR-96抑制物组)后,用细胞划痕实验及Transwell细胞侵袭实验分别检测细胞迁移及侵袭能力,qRT-PCR及Western blot分别测定PTPN9 mRNA及蛋白的表达。结果:miR-96在各肝癌细胞系中的相对表达量均明显高于其在正常肝细胞系L02的相对表达量(均P0.01)。与阴性对照组比较,细胞划痕愈合率在miR-96模拟物组明显升高,而在miR-96抑制物组明显降低(均P0.05);侵袭细胞数在miR-96模拟物组明显增多,而在miR-96抑制物组明显减少(均P0.05);PTPN9 mRNA与蛋白相对表达量在miR-96模拟物组均明显下调,而在miR-96抑制物组均明显上调(均P0.05)。结论:miR-96在HCC细胞中表达升高,并可能通过下调PTPN9表达促进HCC细胞的迁移与侵袭。     

miR-18a-3p在肝癌中的表达及其调控ADCY1表达对肝癌细胞侵袭及增殖的影响

背景与目的 研究表明多种microRNA（miRNA）可能在肝癌的发生发展中发挥重要作用,其作用机制仍值得进一步研究和探讨。因此,本研究从已报道的肝癌差异表达miRNA中进一步筛选关键miRNA,并验证和探讨其作用机制。方法 从已发表的研究中筛选出肝癌组织及肝癌患者血清/血浆中与正常肝组织及正常血清/血浆中共同的差异表达miRNA;用qRT-PCR在正常肝细胞与肝癌细胞中对筛选出的目标miRNA表达情况进行验证;用过表达和抑制的方法观察目标miRNA对肝癌细胞侵袭能力（Transwell实验）与增殖能力（MTT实验）的影响,以及在30例临床标本中检测目标miRNA的表达并通过KM plotter网站分析其对肝癌患者生存的影响;通过miRDB和GEPIA数据库预测和分析目标miRNA的靶基因,并用逆转实验和双荧光素酶报告实验进一步验证。结果 在肝癌组织（vs.正常肝组织）及肝癌患者血清/血浆（vs.正常人血清/血浆）中共同高表达的miRNA有4个（miR-18a-3p、miR-221-3p、miR-222-3p、miR-224-3p）,共同低表达的miRNA有2个（miR-26a-3p、miR-125b-3p）。qRT-PCR实验证实,与正常肝细胞比较,miR-18a在肝癌细胞中高表达,miR-26a在肝癌细胞中低表达（均P<0.05）。过表达/抑制miR-18a-3p表达能促进/降低肝癌细胞的侵袭及生长能力（均P<0.05）,而过表达/抑制miR-26a-3p对肝癌细胞的侵袭及生长能力影响无不法确定。分析结果显示,ADCY1是miR-18a-3p的靶基因,过表达ADCY1能部分逆转miR-18a-3p对肝癌细胞的上述作用,同时,表达上调的miR-18a-3p能通过结合到ADCY1 mRNA 3''UTR抑制ADCY1的表达。结论 miR-18a-3p可能在肝癌的发生发展中起了关键作用,其在肝癌中表达上调,并能通过抑制下游靶基因ADCY1的表达增强进肝癌细胞的侵袭和增殖能力。     

二氢杨梅素的抗肿瘤机制研究进展

二氢杨梅素（Dihydromyricetin,DHM）是从葡萄科植物—藤茶茎叶部中提取出来的多酚羟基双氢黄酮醇类化合物。当代药理学已有的研究表明其抗肿瘤作用,能够明显抑制肺癌、肝癌、胃癌等细胞的发展并诱导其凋亡。现有研究表明DHM抗肿瘤机制主要有抑制肿瘤细胞周期、干预线粒通路以及对肿瘤相关信号通路的调控等途径。     

Fibulin-5表达对膀胱癌细胞迁移和侵袭能力的影响

目的 探讨fibulin-5表达在膀胱尿路上皮癌中的影响作用. 方法 经尿道切除获取膀胱尿路上皮癌标本20例,其中低级别(G_1和G_2)13例、高级别(G_3)7例.蛋白质印迹法检测fibulin-5在膀胱尿路上皮癌和正常膀胱黏膜组织中的表达.将PCR扩增的fibulin-5 cDNA克隆到pMD-19T载体中,构建p-EGFP-fibulin-5质粒.脂质体介导法将p-EGFP-fibulin-5质粒转染到人膀胱癌5637细胞株内,流式细胞仪分选,经G418筛选形成稳定的表达克隆.Boyden小室法检测未转染、转染空载体和转染fibulin-5的膀胱癌细胞迁移和侵袭能力. 结果 正常膀胱黏膜、低级别和高级别膀胱尿路上皮癌组织中fibulin-5蛋白相对表达量分别为1.16±0.28、0.57±0.32和0.44±0.42.与正常膀胱黏膜相比,膀胱癌组织中fibulin-5蛋白表达显著下调(P<0.01),低级别和高级别癌之间差异无统计学意义(P>0.05).转染成功的膀胱癌5637细胞显示绿色荧光.未转染、转染空载体和转染fibulin-5的膀胱癌细胞的迁移细胞数分别为136.9±5.7、139.3±7.7和127.6±3.1,侵 袭细胞数分别为31.7±4.7、31.5±4.8和8.05±3.1.转染fibulin-5后膀胱癌细胞侵袭力明显降低 (P<0.01),其迁移力虽低于对照组但差异无统计学意义(P>0.05). 结论 Fibulin-5蛋白表达减 少可能是膀胱癌发生和发展的机制之一,过表达fibulin-5可以抑制膀胱癌细胞侵袭力.     

CO2气腹环境对胃癌细胞黏附与侵袭转移的影响

目的 探讨不同压强持续性CO2气腹环境对胃癌细胞黏附与侵袭转移的影响.方法 建立体外CO2气腹模型,选用3种不同分化程度的胃癌细胞株MKN-45(低分化腺癌细胞)、SGC-7901(中分化腺癌细胞)和MKN-28(高分化腺痛细胞),分别在9 mm Hg、15 mm Hg以及常规条件下(0 mm Hg,对照组)作用2 h和4 h后,用RT-PCR法、CytoMatrixTM细胞黏附试剂盒和ECMatrixTM细胞侵袭试剂盒检测黏附分子E钙黏蛋白(E-cadherin)和细胞间黏附分子1(intercellular adhesionmolecule-1,ICAM-1)以及侵袭分子基质金属蛋白酶2(matrix metalloproteinases,MMP-2)和血管内皮生长因子A(vascular endothelial growth factor A,VEGF-A)的表达.将胃癌细胞注入裸鼠腹腔(2×106个细胞/只),每组10只.4周后每组取5只处死,记录腹腔成瘤情况,观察其余裸鼠的生存时间.结果 RT-PCR结果显示3种胃癌细胞株经CO2处理后,随着时程的延长及压强的升高,E-cadherin表达有下降的趋势(MKN-45:2.26→2.19、SGC-7901:2.16→2.09、MKN-28:2.06→1.99),而ICAM-1(MKN-45:2.20→2.28、SGC-7901:2.10→2.18、MKN-28:2.00→2.08)、MMP-2(MKN-45:2.05→2.13、SGC-7901:1.95→2.03、MKN-28:1.85→1.93)和VEGF-A(MKN-45:2.10→2.16、SGC-7901:2.00→2.06、MKN-28:1.90→1.96)则有升高的趋势,但是各实验组之间比较或实验组与对照组之间比较差异均无统计学意义(P>0.05).黏附侵袭实验也得出类似的结果.裸鼠模型显示3种胃癌细胞株在不同CO2气腹环境及对照条件下,腹腔成瘤个数随着时程的延长及压强的升高而增加(MKN-45:22→23、SGC-7901:20→22、MKN-28:21→22),存活天数则减少(MKN-45:23→21、SGC-7901:22→21、MKN-28:22→21),但各组的腹腔成瘤个数和存活时间之间相比差异均尤统计学意义(P>0.05).结论 在不高于15 mm Hg 压强以及不超过4 h的情况下,不同压强与时程的CO2对3种胃癌细胞株的黏附和侵袭能力并无显著影响,且不增加肿瘤的转移风险.     

CO2气腹环境对胃癌细胞黏附与侵袭转移的影响

Objective To investigate the influence of CO2 pneumoperitoneum on the adhesive and invasive ability of gastric cancer cells based on the expression of adhesive and invasive molecules. Methods With an artificial CO2 pneumoperitoneum model in vitro, human gastric cancer cells MKN-45, SGC-7901 and MKN-28 were exposed to 3 different CO2 gradients: 9 mm Hg, 15 mm Hg and control group (0 mm Hg). The expression of E-cadherin, ICAM-1, MMP-2 and VEGF-A were measured at 2 and 4 hours exposure by using RT-PCR, CytoMatrixTM kit and ECMatrixTM kit. The pretreated gastric cancer cells were injected into abdominal cavity of nude mice(2×106 cells per mouse). Five mice in each group were sacrificed 4 weeks later to record the number of tumor nodules in abdominal cavity. The remaining mice were kept for observation of survival time. Results The expression of E-cadherin (MKN-45: from 2.26 to 2.19, SGC-7901 :from 2.16 to 2.09、MKN-28 :from 2.06 to 1.99), ICAM-1 (MKN-45 : from 2.20 to 2.28、SGC-7901: from 2.10 to 2.18、MKN-28: from 2.00 to 2.08), MMP-2 (MKN-45:from 2.05 to 2.13、SGC-7901: from 1.95 to 2.03、MKN-28: from 1.85 to 1.93) and VEGF-A(MKN-45 : from 2.10 to 2.16、SGC-7901 :from 2.00 to 2.06、MKN-28: from 1.90 to 1.96) didn't change significantly with increasing pressure and time (P>0.05). The expression of adhesive and invasive molecules didn't change significantly between the experimental groups and the control group. There was no statistical significance of tumor metastasis in abdominal cavity of nude mice(MKN-45:from 22 to 23、SGC-7901 :from 20 to 22、MKN-28:from 21 to 22) and survival time(MKN-45 :from 23 to 21、SGC-7901 :from 22 to 21、MKN-28 :from 22 to 21) among all the groups. Conclusion Under low pressure and short time of CO2 exposure, the adhesive and invasive capacity of gastric cancer cells did not change significantly hence did not increase the possibility of neoplasm metastasis.     

CO2气腹环境对胃癌细胞黏附与侵袭转移的影响

Objective To investigate the influence of CO2 pneumoperitoneum on the adhesive and invasive ability of gastric cancer cells based on the expression of adhesive and invasive molecules. Methods With an artificial CO2 pneumoperitoneum model in vitro, human gastric cancer cells MKN-45, SGC-7901 and MKN-28 were exposed to 3 different CO2 gradients: 9 mm Hg, 15 mm Hg and control group (0 mm Hg). The expression of E-cadherin, ICAM-1, MMP-2 and VEGF-A were measured at 2 and 4 hours exposure by using RT-PCR, CytoMatrixTM kit and ECMatrixTM kit. The pretreated gastric cancer cells were injected into abdominal cavity of nude mice(2×106 cells per mouse). Five mice in each group were sacrificed 4 weeks later to record the number of tumor nodules in abdominal cavity. The remaining mice were kept for observation of survival time. Results The expression of E-cadherin (MKN-45: from 2.26 to 2.19, SGC-7901 :from 2.16 to 2.09、MKN-28 :from 2.06 to 1.99), ICAM-1 (MKN-45 : from 2.20 to 2.28、SGC-7901: from 2.10 to 2.18、MKN-28: from 2.00 to 2.08), MMP-2 (MKN-45:from 2.05 to 2.13、SGC-7901: from 1.95 to 2.03、MKN-28: from 1.85 to 1.93) and VEGF-A(MKN-45 : from 2.10 to 2.16、SGC-7901 :from 2.00 to 2.06、MKN-28: from 1.90 to 1.96) didn't change significantly with increasing pressure and time (P>0.05). The expression of adhesive and invasive molecules didn't change significantly between the experimental groups and the control group. There was no statistical significance of tumor metastasis in abdominal cavity of nude mice(MKN-45:from 22 to 23、SGC-7901 :from 20 to 22、MKN-28:from 21 to 22) and survival time(MKN-45 :from 23 to 21、SGC-7901 :from 22 to 21、MKN-28 :from 22 to 21) among all the groups. Conclusion Under low pressure and short time of CO2 exposure, the adhesive and invasive capacity of gastric cancer cells did not change significantly hence did not increase the possibility of neoplasm metastasis.     

CO2气腹环境对胃癌细胞黏附与侵袭转移的影响

Objective To investigate the influence of CO2 pneumoperitoneum on the adhesive and invasive ability of gastric cancer cells based on the expression of adhesive and invasive molecules. Methods With an artificial CO2 pneumoperitoneum model in vitro, human gastric cancer cells MKN-45, SGC-7901 and MKN-28 were exposed to 3 different CO2 gradients: 9 mm Hg, 15 mm Hg and control group (0 mm Hg). The expression of E-cadherin, ICAM-1, MMP-2 and VEGF-A were measured at 2 and 4 hours exposure by using RT-PCR, CytoMatrixTM kit and ECMatrixTM kit. The pretreated gastric cancer cells were injected into abdominal cavity of nude mice(2×106 cells per mouse). Five mice in each group were sacrificed 4 weeks later to record the number of tumor nodules in abdominal cavity. The remaining mice were kept for observation of survival time. Results The expression of E-cadherin (MKN-45: from 2.26 to 2.19, SGC-7901 :from 2.16 to 2.09、MKN-28 :from 2.06 to 1.99), ICAM-1 (MKN-45 : from 2.20 to 2.28、SGC-7901: from 2.10 to 2.18、MKN-28: from 2.00 to 2.08), MMP-2 (MKN-45:from 2.05 to 2.13、SGC-7901: from 1.95 to 2.03、MKN-28: from 1.85 to 1.93) and VEGF-A(MKN-45 : from 2.10 to 2.16、SGC-7901 :from 2.00 to 2.06、MKN-28: from 1.90 to 1.96) didn't change significantly with increasing pressure and time (P>0.05). The expression of adhesive and invasive molecules didn't change significantly between the experimental groups and the control group. There was no statistical significance of tumor metastasis in abdominal cavity of nude mice(MKN-45:from 22 to 23、SGC-7901 :from 20 to 22、MKN-28:from 21 to 22) and survival time(MKN-45 :from 23 to 21、SGC-7901 :from 22 to 21、MKN-28 :from 22 to 21) among all the groups. Conclusion Under low pressure and short time of CO2 exposure, the adhesive and invasive capacity of gastric cancer cells did not change significantly hence did not increase the possibility of neoplasm metastasis.     

CO2气腹环境对胃癌细胞黏附与侵袭转移的影响

Objective To investigate the influence of CO2 pneumoperitoneum on the adhesive and invasive ability of gastric cancer cells based on the expression of adhesive and invasive molecules. Methods With an artificial CO2 pneumoperitoneum model in vitro, human gastric cancer cells MKN-45, SGC-7901 and MKN-28 were exposed to 3 different CO2 gradients: 9 mm Hg, 15 mm Hg and control group (0 mm Hg). The expression of E-cadherin, ICAM-1, MMP-2 and VEGF-A were measured at 2 and 4 hours exposure by using RT-PCR, CytoMatrixTM kit and ECMatrixTM kit. The pretreated gastric cancer cells were injected into abdominal cavity of nude mice(2×106 cells per mouse). Five mice in each group were sacrificed 4 weeks later to record the number of tumor nodules in abdominal cavity. The remaining mice were kept for observation of survival time. Results The expression of E-cadherin (MKN-45: from 2.26 to 2.19, SGC-7901 :from 2.16 to 2.09、MKN-28 :from 2.06 to 1.99), ICAM-1 (MKN-45 : from 2.20 to 2.28、SGC-7901: from 2.10 to 2.18、MKN-28: from 2.00 to 2.08), MMP-2 (MKN-45:from 2.05 to 2.13、SGC-7901: from 1.95 to 2.03、MKN-28: from 1.85 to 1.93) and VEGF-A(MKN-45 : from 2.10 to 2.16、SGC-7901 :from 2.00 to 2.06、MKN-28: from 1.90 to 1.96) didn't change significantly with increasing pressure and time (P>0.05). The expression of adhesive and invasive molecules didn't change significantly between the experimental groups and the control group. There was no statistical significance of tumor metastasis in abdominal cavity of nude mice(MKN-45:from 22 to 23、SGC-7901 :from 20 to 22、MKN-28:from 21 to 22) and survival time(MKN-45 :from 23 to 21、SGC-7901 :from 22 to 21、MKN-28 :from 22 to 21) among all the groups. Conclusion Under low pressure and short time of CO2 exposure, the adhesive and invasive capacity of gastric cancer cells did not change significantly hence did not increase the possibility of neoplasm metastasis.     

microRNA-25高表达与直肠癌细胞的侵袭和迁移的关系

目的:探讨micro RNA-25(mi R-25)在直肠癌细胞中的表达及作用。方法:检测多种不同直肠癌细胞中mi R-25的表达,并检测直肠癌细胞转染mi R-25前体(pre-mi R-25)上调mi R-25的表达或转染mi R-25抑制剂(anti-mi R-25)下调mi R-25的表达后生物学行为的变化。结果:与正常直肠黏膜组织比较,不同的直肠癌细胞中mi R-25的表达均不同程度的明显升高(均P0.05)。在mi R-25表达水平相对较低的直肠癌HR-834细胞中转染pre-mi R-25,在mi R-25高表达的直肠癌SW-837细胞中转染anti-mi R-25后,两种细胞的增殖、细胞周期、凋亡无明改变(均P0.05),但侵袭及迁移能力在HR-834细胞的明显增强,SW-837细胞减弱(均P0.05)。结论:mi R-25在直肠癌细胞中的表达升高,且其升高程度与细胞的侵袭和迁移能力密切相关。     

长链非编码RNA MALAT1在肝癌组织中的表达及其在肝癌细胞增殖与侵袭转移中的作用

目的:探讨长链非编码RNA MALAT1在肝癌组织中的表达及意义。方法:用qRT-PCR检测85例肝癌组织及其配对癌旁组织中MALAT1的表达,分析MALAT1的表达与肝癌患者临床病理因素的关系;在肝癌SMMC-7721细胞中分别过表达与敲除基因MALAT1后,通过CCK-8与Transwell实验检测肝癌细胞增殖与侵袭转移能力的改变。结果:MALAT1在肝癌组织中的表达明显高于癌旁正常组织(P0.01);MALAT1在肝癌组织中的表达与肿瘤大小、肝癌的分化程度、TNM分期、淋巴结转移明显有关(均P0.05)。肝癌SMMC-7721细胞过表达MALAT1后增殖、侵袭与转移能力明显增强,而敲低MALAT1后增殖、侵袭与转移能力明显减弱(均P0.05)。结论:MALAT1在肝癌组织中表达上调,MALAT1可促进肝癌细胞增殖、侵袭与转移,故可能与肝癌的发生发展密切相关。     

免疫抑制剂对肝癌细胞增殖、运动侵袭的影响

目的探讨免疫抑制剂对肝癌细胞增殖、运动侵袭能力的影响,为肝癌肝移植术后免疫抑制剂的选用提供指导。方法用裸鼠人高转移肝癌模型LCI-D20,研究环孢素A(CsA)、他克莫司(FK506)、雷帕霉索(RPM)对肿瘤生长及自发肺转移的影响。采用扫描电镜、噻唑蓝比色法 (MTT)、流式细胞仪、Boyden小室等方法分别研究各免疫抑制剂对人肝癌高转移细胞株 MHCC97H增殖、凋亡、细胞周期、运动及侵袭的影响。结果体内实验中,RPM抑制了LCI-D20 模型移植瘤的生长[(0．76±0．38)g vs(2．09±0．75)g,P<0．05]及肺转移的发生(2／7 vs．7／7, P<0．05);CsA组肺部转移灶的数目明显多于对照组(6±2 vs．4±1,P<0．05);FK506组肺转移发生率虽较对照组减少,但差异无统计学意义。CsA及FK506均对移植瘤的生长无影响。体外实验中,RPM抑制了MHCC97H增殖,并使细胞周期停滞于G_0-G_1期。RPM及FK506抑制了 MHCC97H的运动、侵袭(P<0．05),而CsA则促进了MHCC97H的运动、侵袭(P<0．05)。结论 CsA促进了肝癌的转移;FK506不促进肝癌的转移;而RPM则抑制了肝癌细胞的增殖及转移。     

术前预测肝细胞癌并微血管侵犯的研究进展

肝细胞癌(HCC)是常见恶性肿瘤之一,手术和肝移植是目前可治愈的手段,但是术后易复发,预后较差。微血管侵犯是(MVI)独立的预后因素,其术前诊断成为研究的热点。笔者就目前的术前预测HCC并微MVI的研究进展进行综述。     

肝细胞癌患者介入手术后胆汁瘤发病因素与临床特点

目的:探讨肝细胞癌患者介入手术后胆汁瘤发病因素与临床特点。方法:回顾性分析2013年1月—2015年1月期间500例经肝动脉化疗栓塞介入手术(TACE)治疗的肝细胞癌患者的临床资料,分析患者手术后胆汁瘤发病的危险因素和临床表现。结果:500例患者中45例(9.0%)术后发生胆汁瘤。统计分析显示,存在胆道扩张、TACE术前肝切除史、非超选择性插管、使用聚乙烯醇(PVA)颗粒是患者介入手术后发生胆汁瘤的危险因素(均P0.05)。45例胆汁瘤患者中10例为有症状胆汁瘤患者,主要为黄疸和发热,且胆汁瘤直径明显高于无症状患者(8.12 mm vs.21.84 mm,P0.05),穿刺引流治疗后8例患者胆汁瘤缩小,2例消失;35例无症状组患者定期影像学随访。结论:对于有危险因素的肝细胞癌患者,应积极做术前好评估和预防工作。有症状的胆汁瘤患者应当进行穿刺置管引流治疗,无症状的胆汁瘤患者应当进行影像学随访,若胆汁瘤增大需要进行穿刺置管引流治疗,均能取得良好的预后。     

肝癌的转化医学研究——从基础到临床

肝细胞癌的总体疗效不佳,基础研究与临床实践之间的巨大鸿沟是导致疗效难以进一步提高的瓶颈。转化医学从肝癌的早期诊断、药物筛选、干预新策略的制定、现有治疗方法不足的弥补以及复发转移的早期预测等方面为肝癌实现从基础研究到临床实践的跨越搭建了重要桥梁。     

精准肝切除治疗肝细胞癌关键技术

21世纪初肝脏外科的进展是精准、微创和有效,肝切除作为肝细胞癌的主要治疗手段之一,业已进入精准肝切除时代,但精准肝切除治疗肝细胞癌的关键技术目前尚不明确。笔者在系统临床探索的基础上,提出其关键技术包括4个方面:精确评估规划技术、精准肝门解剖技术、精细肝实质离断技术与精良术后管理技术。临床迫切需要对精准肝切除治疗肝细胞癌的关键技术进行标准化,从循证医学的角度评估精准肝切除治疗肝细胞癌的有效性和手术安全性,将精准肝切除作为一门适宜技术在国内进一步推广。     

乙型肝炎病毒感染及抗病毒治疗对肝细胞癌微血管侵犯的影响

目的:探讨乙型肝炎病毒(HBV)感染及抗病毒治疗对肝细胞癌微血管侵犯(MVI)形成的影响。方法:回顾性分析青岛大学附属医院2015年1月—2017年12月660例行根治性肝切除手术的肝细胞癌患者的临床及病理资料。结果:660例患者中,MVI发生率为46.8%(309/660)。单因素分析显示,MVI的形成与HBsAg阳性、可检测的HBV DNA载量以及是否行抗病毒治疗有关,此外,还与患者的年龄、性别、术前AFP、肿瘤标志物、肝功能指标、组织学分级、肿瘤大小与数目、包膜是否完整以及是否存在卫星结节有关(均P0.05)。在HBV相关患者中,多因素Logistic回归分析结果显示:可检测的HBV DNA载量(OR=5.33,P0.001)为MVI的独立危险因素,而抗病毒治疗半年以上(OR=0.37,P=0.002)为MVI的独立保护因素,MVI的其他独立影响因素还包括性别、AFP水平、肿瘤直径、组织学分级、包膜不完整、存在卫星结节(均P0.05)。重度MVI患者有明显高的HBV感染、高HBV DNA载量(100 IU/mL)以及未行抗病毒治疗的比例较轻度MVI及无MVI患者明显升高(均P0.05),此外,轻度MVI患者中肝硬化比例较高(80.0%)。结论:HBV感染与HBV DNA水平是肝细胞癌MVI的形成的重要因素,抗病毒治疗可能对MVI的形成有预防作用。