肝细胞肝癌预后与病理特征、PCNA和DNA指数的关系

目的　研究肝细胞肝癌 (HCC)患者预后与肿瘤的病理形态特征、PCNA指数及DNA指数的关系。方法　分析 5 1例中等分化HCC患者的临床、随访资料及病理形态特征 ;应用免疫组织化学方法检测其PCNA阳性指数 ;应用图像分析仪进行DNA指数测量。结果　癌灶单个 ,直径≤ 5cm ,无癌栓、无肿瘤旁子灶及癌性坏死患者预相对较好 ;DNA整数倍体预后好于非整倍体 ,非整倍体中DI<1.5者又好于 >1.5者 ;PCNA指数越高 ,患者预后越差 ;DI与PCNA指数有一定的相关 ,且两者与病理形态特征间也有关联。结论　进行病理形态学和PCNA、DNA指数的前瞻性综合分析是评估患者术后是否高危复发及其预后的有效方法

Relationship of Prognosis and Pathological Characteristics,PCNA Index and DNA Index in Patients with Hepatocelluar Carcinoma

Purpose To study the relationships of prognosis and pathological characteristics,proliferating cell nuclear antigen(PCNA) index and DNA index(DI) in patients with medium differentiated hepatocelllar carcinoma(HCC). Methods 51 cases of HCC of medium differentiation in pathological diagnosis were analyzed at the aspects of clinical follow up data and pathological characteristics.Meanwhile,PCNA labeling index of HCC cells was detected by means of immunohistochemistry and DI was measured by Feulgen stain and automatic image analysis technique. Results Patients with HCC of a single tumour nodule,less than 5 cm in diameter,no tumor embolus,no satellite nodule and no tumor necrosis got relatively better prognosis; Patients with euploid HCC had better prognosis than those with aneuploid,and among the aneuploid patients with DI<1.5 had better prognosis than the cases with DI>1.5;The higher the PCNA index detected,the worse the prognosis patients had.The increase of DI was correlated with the increase of PCNA,and both of them were correlated with the pathological changes of the tumours. Conclusions Synthetical analysis of the tumor pathological characteristics,DI and PCNA index are very useful in predicting the prognosis of patients with HCC.