NRP-1在肝细胞癌组织中的表达及其临床意义

目的 明确神经纤毛蛋白质1(NRP-1)在肝细胞癌(HCC)组织中的表达情况及其临床意义.方法 收集151例HCC组织和89例正常肝组织标本,应用免疫组织化学染色法检测其中NRP-1蛋白的表达情况.单因素及多因素统计分析NRP-1表达与HCC患者临床病理指标的关系,并以生存分析比较不同NRP-1表达水平患者的生存情况.结果 失访或随访期间因非HCC疾病死亡的病例共11例,最终进入研究的有效病例为140例.NRP-1在HCC组织和正常肝组织中的阳性表达率分别为65.00％、35.96％,差异有统计学意义(x2=18.843,P＜0.001).按照NRP-1的表达水平,将140例HCC患者分为阴性表达组49例,阳性表达组91例.单因素分析结果显示,NRP-1在HCC中的表达与肿瘤数目(x22=8.025,P=0.005)、TNM分期(x2=26.467,P ＜0.001)、分化程度(x2=15.296,P ＜0.001)、门脉侵袭(x2=9.054,P=0.003)以及肝静脉侵袭(x2=5.928,P=0.015)有关.多因素分析结果显示,TNM分期(OR=1.392,95％ CI为1.121 ～1.730,x2=8.950,P=0.003)、分化程度(OR=1.469,95％ CI为1.102 ～1.958,x2 =6.862,P =0.009)、门脉侵袭(OR=1.829,95％ CI为1.157 ～ 2.893,x2=6.665,P=0.010)及肝静脉侵袭(OR =2.161,95％ CI为1.172 ～3.987,x2=6.084,P=0.014)是NRP-1表达的影响因素.NRP-1阴性组HCC患者的中位生存时间显著长于阳性组患者(44个月∶23个月),差异有统计学意义(x2=21.922,P＜0.001).结论 NRP-1在HCC组织中呈过表达趋势,与HCC的恶性程度密切相关,其表达增高提示患者预后不良.

Expression and clinical value of NRP-1 in hepatocellular carcinoma

Objective To determine the expression and clinical value of neuropilin-1 (NRP-1) in hepatocellular carcinoma (HCC).Methods One hundred and fifty-one cases of HCC tissues and 89 cases of healthy liver tissues were chosen to compare the expression of NRP-1 by immunohistochemistry.Then the relationships between different clinical factors and the expression of NRP-1 were analyzed by univariate and multivariate statistical analysis.Moreover,the survival rates were compared by survival analysis between different expressions of NRP-1 in HCC patients.Results Eleven cases were lost to follow-up or died for non HCC disease,and the effective cases in the final study were 140 cases.The positive expression rates of NRP-1 in HCC and normal liver tissues were 65.00％ and 35.96％ respectively,and the difference was statistically significant (x2 =18.843,P ＜0.001).According to the expression level of NRP-1,140 patients with HCC were divided into negative expression group (n =49) and positive expression group (n =91).Univariate analysis showed that the expression of NRP-1 in HCC was correlated with tumor number (x2 =8.025,P =0.005),TNM stage (x2 =26.467,P ＜ 0.001),differentiation degree (x2 =15.296,P ＜ 0.001),portal vein invasion (x2 =9.054,P =0.003) and hepatic vein invasion (x2 =5.928,P =0.015).Multivariate statistical analysis showed that TNM stage (OR =1.392,95％ CI:1.121-1.730,x2 =8.950,P =0.003),differentiation degree (OR =1.469,95％ CI:1.102-1.958,x2 =6.862,P =0.009),portal vein invasion (OR =1.829,95％ CI:1.157-2.893,x2 =6.665,P =0.010) and hepatic vein invasion (OR =2.161,95％ CI:1.172-3.987,x2 =6.084,P =0.014) were important factors for NRP-1 expression.The median survival time of NRP-1 negative HCC patients was significantly longer than that of positive group (44 months vs.23 months),and the difference was statistically significant (x2 =21.922,P ＜0.001).Conclusion NRP-1 is over-expression in HCC tissue and related to the malignant progress of HCC,and this suggests poor prognosis in patients with HCC.