肝癌组织骨桥蛋白及CD44v6的表达与肝癌肝移植术患者预后的意义研究

目的研究骨桥蛋白(OPN)、CD44v6预测肝细胞癌肝移植患者预后效能,为寻求新的受体选择标准提供理论依据。方法收集2002年8月至2006年7月期间在西安交通大学医学院第一附属医院行经典原位肝移植术,且病理确诊为肝细胞癌的病例共30例。应用组化染色法,检测OPN、CD44v6的表达,进行统计分析。结果 30例肝细胞肝癌组织中OPN和CD44v6表达正相关。肝移植术后肿瘤复发转移与符合米兰标准情况显著负相关(P<0.01),与OPN、CD44v6的表达正相关(P<0.05)。在超出米兰标准的患者中,肿瘤复发与OPN、CD44v6阳性表达的相关性更强(P<0.01)。随访期内OPN或CD44v6染色阳性患者的生存率明显低于阴性患者(P=0.001),双阳性患者的生存率最低。对于超米兰标准的肝移植患者更为显著(P=0.004)。结论 OPN、CD44v6可以作为预测肝细胞癌肝移植患者预后的预测标签,联合检测OPN、CD44v6能够更好地反映超米兰标准的肝移植患者预后,检测OPN、CD44v6可以纳入受体选择标准。

Study of the significance of OPN and CD44v6 expression in heptocellular carcinoma with prognosis of patients underwent liver transplantation

Objective To study the correlation between expression of osteopontin(OPN) and CD44v6 and prognosis in patients with heptocellular carcinoma(HCC) underwent orthotopic liver transplantation(OLT),in order to provide theoretical evidence for searching new criteria of receptor selection.Methods Thirty specimens were collected from patients with HCC underwent liver transplantation from Aug.2002 to Jul.2006,in the First Affiliated Hospital of Xi’an Jiao Tong University.The expression of OPN and CD44v6 was detected with immunohistochemical technique.The associations of these indexes were analyzed by SPSS 14.0.Results OPN and CD44v6 expression was positively correlated with each other.The recurrence and metastasis of HCC after OLT was negatively correlated with the Milan criteria(P<0.01),and was positively correlated with OPN and CD44v6 expression(P<0.05).The recurrence and metastasis had more significant correlation with OPN and CD44v6 in patients did not accord with the Milan criteria(P<0.01).During follow up period,the survival rate in patients with positive OPN or CD44v6 expression was much lower than the ones with negative expression(P=0.001),both of which were positively expressed had the lowest survival rate.In patients did not accord with the Milan criteria,the survival rate was significantly correlated with OPN and CD44v6 expression(P=0.004).Conclusion OPN and CD44v6 can be used as prognostic markers in HCC patients after OLT.Combing tests of OPN and CD44v6 could better predict prognosis of patients do not accord with the Milan criteria.OPN and CD44v6 tests may be included into the receptor selection criteria of liver transplantation.