肝细胞肝癌中端粒酶、p53和CK19的表达及意义

目的探讨端粒酶、p53和CK19在肝细胞肝癌(hepatocellular carcinoma,HCC)组织中的表达及其临床病理意义。方法应用组织芯片技术和免疫组化SP法检测272例HCC及81例癌旁组织中端粒酶、p53和CK19的表达情况,并分析其与临床病理特征及预后的关系。结果 (1)272例HCC中端粒酶、p53和CK19的阳性率分别为56.62%(154/272)、12.90%(35/272)和14.30%(39/272),均高于癌旁组织的9.88%(8/81)、0(0/81)和0(0/81),差异均有显著性(P<0.01)。(2)端粒酶在HCC中的表达与术后无瘤生存时间、组织学分级、肿瘤直径、卫星灶、脉管癌栓及临床分期有关(P<0.05),与其他指标无关(P均>0.05);p53在HCC中的表达与术后无瘤生存时间、组织学分级、肝被膜浸润、血中AFP含量及淋巴结转移有关(P<0.05),与其他指标无关(P均>0.05);CK19在HCC中的表达与术后无瘤生存时间、组织学分级、肿瘤直径、肝硬化、卫星灶、淋巴结转移及临床分期有关(P<0.05),与其他指标无关(P>0.05)。(3)三者在HCC中的表达互呈正相关(端粒酶与p53:r=0.137,P=0.024;端粒酶与CK19:r=0.497,P=0.001;p53与CK19:r=0.274,P=0.005)。(4)Kaplan-Meier生存分析结果显示:HCC组织中端粒酶、p53和CK19阳性的患者生存时间缩短。结论 HCC中端粒酶、p53和CK19的阳性表达与多种临床病理指标相关,三者均可作为HCC患者预后不良的判断因子。

Expression of telomerase, p53 and CK19 and their significance in hepatocellular carcinoma

Purpose To investigate the expression of telomerase,p53 and CK19 protein and their clinicopathologic significance in hepatocellular carcinoma(HCC).Methods The expression of telomerase,p53 and CK19 protein was determined by tissue microarray and immunohistochemistry in 272 cases of HCC and 81 cases non-cancerous tissue.The relationships between their expression and the clinicopathologic parameters,the survival time of patients were analyzed.Results The positive rates of telomerase,p53 and CK19 in HCC were 56.62%,12.90% and 14.30%,respectively,which were higher than those in nocancerous tissue(P<0.01).The expression of telomerase in HCC was closely correlated to the survival time,histological grade,tumor size,microsatellites,cancer embolus of vessel and TNM clinical stage(P<0.05),but not to the rest of parameters(all P>0.05);the expression of p53 in HCC was closely correlated to the survival time,histological grade,liver capsule invasion,AFP level and lymph node metastasis(P<0.05),but not to the rest of parameters(all P>0.05),and the expression of CK19 in HCC was closely correlated to the survival time,histological grade,tumor diameter,liver cirrhosis,microsatellites,lymph node metastasis and TNM clinical stage(P<0.05),but not to the others(all P>0.05).The three biomarkers were positively interrelated(the telomerase to p53: r=0.137,P=0.024;the telomerase to CK19: r=0.497,P=0.001;the p53 to CK19: r=0.274,P=0.005).The positive expression of telomerase,p53 and CK19 was significantly related to short-term survival by Kaplan-Meier analysis.Conclusions The positive expression of telomerase,p53 and CK19 closely correlates with multiple clinicopathologic parameters,which may indicate the poor prognosis of HCC.