生物钟基因Per3在肝细胞癌中的表达及临床意义

目的研究生物钟基因Per3在肝细胞癌（HCC）中的表达与临床意义。 方法选取2010年1月1日至2013年12月31日在深圳市人民医院肝胆外科行肝癌根治性切除术且经病理证实的120例肝癌患者的癌组织及癌旁组织。采用免疫组化法检测肝癌和癌旁组织中Per3蛋白的表达，并分析其表达与临床病理特征的关系。采用Kaplan-Meier时间生存曲线分析Per3表达与患者预后的关系。 结果肝癌组织中Per3蛋白的表达较癌旁组织显著降低，两者比较差异具有统计学意义（χ²=13.02，P<0.01）。在肝癌组织中Per3蛋白低表达的患者肿瘤数目≥2个、瘤体>5 cm及伴门静脉侵袭的发生率显著升高，差异均具有统计学意义（χ²=12.095，P=0.001；χ²=6.305，P=0.012；χ²=4.461，P=0.035）。Per3低表达的HCC患者总体生存率（OS）与无瘤生存率（DFS）均显著降低（P=0.011、0.036）。 结论Per3蛋白在肝癌组织中呈低表达，与患者肿瘤数目、大小、门脉侵袭密切相关，并影响患者的OS和DFS，可以作为HCC患者肝切除术后的预后指标。

Clinical significance of expression of Per3 in hepatocellular carcinoma

ObjectiveTo detect the expression of Per3 in hepatocellular carcinoma (HCC) and to analyze its clinical significance. MethodsFrom January 1, 2010 to December 31, 2013, 120 patients with hepatocellular carcinoma underwent radical surgery at the Department of Hepatobiliary Surgery of Shenzhen People's Hospital. The expression of Per3 was detected in tumor and peritumoral tissues collected from these surgical patients by immunohistochemistry. The relationship of Per3 expression with the clinical and pathological features and survival was evaluated by chi-square test and Kaplan-Meier analysis. ResultsPer3 expression was significantly lower in HCC tissues than in paired peritumoral liver tissues (χ² = 13.02, P<0.01). The expression of Per3 was significantly related to number of tumor lesions, tumor size, and portal vein invasion (χ² = 12.095, P = 0.001; χ² = 6.305, P = 0.012; and χ² = 4.461, P = 0.035, respectively). Compared to Per3 positive HCC patients, Per3 negative HCC patients had significantly lower overall survival and disease-free survival rates (P = 0.011 and 0.036, respectively). ConclusionPer3 is lowly expressed in HCC tumor tissues. Per3 expression is significantly associated with number of tumor lesions, tumor size, and portal vein invasion, as well as overall survival and disease-free survival. Per3 expression might be used as a prognostic factor for HCC patients after liver resection.