经导管肝动脉化疗栓塞对肝癌细胞nm23、金属蛋白酶组织抑制剂-2表达及肝外转移的影响

目的 探讨经导管肝动脉化疗栓塞术(TACE)对肝癌(HCC)nm23-H1、金属蛋白酶组织抑制剂-2(TIMP-2)基因的表达水平以及癌细胞转移潜能的影响.方法 搜集72例可切除HCC患者手术切除标本,其中36例患者术前行TACE(A组),另外36例直接行手术切除(B组).对手术切除的标本行常规病理、免疫组织化学检查,比较2组切除标本中癌组织、距癌组织2 cm的旁组织nm23-H1、TIMP-2基因的表达水平和分布.所有患者术后均随访24个月,比较2组患者肝外转移的发生率.nm23-H1、TIMP-2表达水平的比较及生存期比较均采用X~2检验.结果 A组患者 nm23-H1表达强阳性24例、弱阳性6例、无表达6例;而B组 nm23-H1表达强阳性9例、弱阳性6例、无表达21例;2组比较差异有统计学意义(X~2=15.52,P<0.01).A组TIMP-2表达强阳性21例、弱阳性3例、无表达12例;B组TIMP-2表达强阳性、弱阳性均为9例,无表达18例;2组比较差异有统计学意义(X~2=9.00,P<0.05).通过24个月随访,A、B 2组出现癌细胞肝外转移的例数分别为13和15例,2组差异没有统计学意义(X~2=0.23,P>0.05).结论 TACE可以提高肝癌组织 nm23-H1、TIMP-2的表达,提示TACE可能抑制肝癌细胞转移潜能.

Transcatheter arterial chemoembolizaion on the expression of nm23, Tissue inhibitor of metalloproteinase-2 and extrahepatic metastasis in hepatocellular carcinoma

Objective To investigate the effects of transcatheter arterial chemoembolization(TACE) on the expression of nm23, tissue inhibitor of metalloproteinase-2 (TIMP-2) and extrahepatic metastasis in hepatocellular carcinoma (HCC). Methods The specimens were collected from resectable HCC in 72 patients. Patients were divided into two groups. In one group, TACE was performed before tumor resection (Group A, n=36). In another group, the tumors were resected directly without preoperative TACE (Group B, n=36). The expression and distribution of nm23, TIMP-2 in the tumor tissue and liver parenchyma in the two groups were compared. All patients were followed up for 24 months,and the incidence of extrahepatic metastasis was compared between the two groups. Chi-square test was applied to compare the expression levels of nm23-H1 and TIMP-2. Results The number of cases of strong, moderate and no expression of nm23 were 24, 6 and 6 cases in group A respectively, and were 9, 6 and 21 cases in group B. Statistical differences were found between the two groups(X~2=15.52, P<0.01). The number of cases of strong, moderate and no expression of TIMP-2 were 21,3 and 12 cases in group A respectively, and were 9, 9 and 18 cases in group B. Statistical differences were demonstrated between them (X~2=9.00, P<0.05). There were 13 cases in group A and 15 cases in group B being diagnosed to have extrahepatic metastasis within 24- month period of follow up, but there was no significant difference between the two groups(X~2= 0.23, P>0.05). Conclusions TACE could enhance the expression of nm23-H1 and TIMP-2 in tumor tissues. Therefore, the potential of metastasis of tumor cells might be prohibited by TACE.