上皮间质转化与肝细胞癌肺转移的相关性研究

目的 研究上皮间质转化和肝细胞癌肺转移的关系.方法 2000年1月至2004年3月于中山医院肝外科手术病理诊断为肝细胞癌的患者中,根据术后随访期内有无肺转移分为有肺转移组和无远处转移组,每组随机选择50例患者的原位肝癌组织制成组织芯片.用免疫组织化学染色(二步法)方法检测组织芯片上肺转移组和无远处转移组患者的肝痛组织的上皮间质转化的标志(E-cadherin、Vimentin、Fibronectin),单因素和多因素分析这些标志和肝细胞癌肺转移的关系.结果 单因素分析了性别、年龄、HbsAg、甲胎蛋白(AFP)、肿瘤大小、数目、癌栓、包膜、肝门淋巴结、肿瘤分化程度、E-钙黏蛋白(E-cadherin)、波形蛋白(Vimentin)、纤维连接蛋白(Fibroneetin)的表达与肺转移的相关性,结果显示:患者AFP水平>400 ng/ml、肿瘤直径>10 cm、门静脉癌栓、分化程度低、E-cadherin的低表达、Fibronectin的高表达、Vimentin的高表达与肝细胞癌肺转移相关;多因素分析显示肿瘤直径>10 cm、门静脉癌栓、分化程度低、Fibronectin高表达是肝细胞癌肺转移的危险因素.结论 肝细胞癌患者肝癌组织的上皮间质转化与其发生肺转移有密切关系.

Relationship between epitheliai-mesenchymal transition and lung metastasis in hepatocellular carcinoma

Objective To evaluate the relationship between epithelial mesenchymal transition (EMT) and lung metastasis in hepatocellular carcinoma. Methods There were 100 patients who underwent surgical resection of hepatocellular carcinoma between January 2000 and March 2004. They were classified with non-distance metastasis and lung metastasis depend on the close following up till March 2007. Their hepatocellular carcinoma specimens were retrospectively examined for EMT markers(E-cadherin, Vimentin,Fibronectin) with immunochemistry staining in tissue microarray. Univariate and multivariate analysis were used for study the relationship between EMT and lung metastasis. Results Univariate analysis showed that down regulation of E-cadherin,overexpression of fibronectin, cytosolic expression of vimentin, AFP≥400 ng/ml, tumor size more than 10 cm, portal vein involvement, poorly differentiated of tumor had close correlation with lung metastasis. Multivariate analysis indicated that overexpression of fibronectin was independent factor for lung metastasis apart from tumor size more than 10 cm, portal vein involvement and poorly differentiated of tumor. Conclusion The results proposed that EMT has close relation with lung metastasis in hepatoceilular carcinoma.