BZW2和IVD在肝癌组织中的表达及其对肝癌肝移植受者预后的影响

目的  探讨碱性亮氨酸拉链和W2结构域2（BZW2）及异戊酰辅酶A脱氢酶（IVD）在肝细胞癌（肝癌）中的表达及其对肝移植受者预后的影响。方法  回顾性分析87例肝癌肝移植受者的病理标本及临床资料，分析肝癌肝移植受者术后肿瘤复发转移情况。采用免疫组织化学染色检测BZW2和IVD的表达情况，分析BZW2和IVD与肝癌临床病理参数的关系及其对肝移植术后肿瘤复发和受者预后的影响。结果  87例受者中，共有31例肿瘤复发，复发率为36%，复发时间为术后2~49个月，复发时间中位数为7个月。免疫组织化学染色结果显示，肝癌组织的BZW2阳性表达率高于正常肝组织（76%比30%），IVD阳性表达率低于正常肝组织（51%比69%），差异均有统计学意义（均为P < 0.01）。BZW2表达与肿瘤直径、有否肿瘤包膜有关（均为P < 0.05），IVD表达与肿瘤直径，甲胎蛋白（AFP）水平，肿瘤、淋巴结、转移（TNM）分期，有否血管侵犯有关（均为P < 0.05）。BZW2高表达组受者肿瘤累积复发率高于BZW2低表达组，累积生存率低于BZW2低表达组；IVD低表达组患者肿瘤累积复发率高于IVD高表达组，累积生存率低于IVD高表达组（均为P < 0.05）。结论  在肝癌组织中，BZW2蛋白表达水平上调，IVD蛋白表达水平下调。且BZW2高表达和IVD低表达的肝移植受者的累积复发率较高，累积生存率较低。

Expression of BZW2 and IVD in hepatocellular carcinoma tissues and effect on prognosis of liver transplant recipients with hepatocellular carcinoma

Objective To investigate the expression levels of basic leucine zipper and W2 domain 2(BZW2)and isovaleryl-CoA dehydrogenase(IVD)in hepatocellular carcinoma(HCC)and evaluate their effect on clinical prognosis of liver transplant recipients with HCC.Methods Pathological specimens and clinical data of 87 liver transplant recipients with HCC were collected and retrospectively analyzed.The recurrence and metastasis of HCC after liver transplantation were assessed.Immunohistochemical staining was used to detect the expression levels of BZW2 and IVD.The relationship between BZW2,IVD and clinicopathological parameters of HCC and their effect on postoperative recurrence and clinical prognosis of the recipients was analyzed.Results Among 87 recipients,31 cases recurred with a recurrence rate of 36%.HCC recurred at postoperative 2-49 months and the median recurrence time was postoperative 7 months.Immunohistochemical staining demonstrated that the positive expression rate of BZW2 in the HCC tissues was significantly higher than that in normal liver tissues(76%vs.30%),and the positive expression rate of IVD was significantly lower compared with that in normal liver tissues(51%vs.69%)(both P<0.01).BZW2 expression was significantly correlated with tumor diameter and tumor capsule(both P<0.05),whereas IVD expression was significantly associated with tumor diameter,alpha-fetoprotein(AFP)level,tumor,node and metastasis(TNM)staging and whether vascular invasion was found or not(all P<0.05).In the high BZW2 expression group,the cumulative recurrence rate of HCC was significantly higher and the cumulative survival rate was significantly lower than those in the low BZW2 expression group.In the low IVD expression group,the cumulative recurrence rate of HCC was significantly higher and the cumulative survival rate was significantly lower compared with those in the high IVD expression group(all P<0.05).Conclusions The expression level of BZW2 protein is up-regulated,whereas that of IVD protein is down-regulated in the HCC tissues.Moreover,the cumulative recurrence rate of HCC is relatively high and the cumulative survival rate is relatively low in liver transplant recipients with high BZW2 expression and low IVD expression.