肝癌组织中CD68+肿瘤相关巨噬细胞数量与Ki-67蛋白表达及原发性肝癌预后的关系

目的 探讨原发性肝癌（HCC）患者肝癌组织中CD68⁺肿瘤相关巨噬细胞（CD68⁺ TAM）的数量与增殖指标Ki-67及肝癌预后的关系，寻找评估肝癌预后更可靠的指标。方法 应用免疫组织化学SABC法检测73例HCC组织中CD68+ TAM的分布情况及增殖指标Ki-67蛋白表达，运用化学发光测定法检测血清AFP水平。结果 CD68⁺ TAM高密度组Ki-67阳性率明显高于低密度组（P=0.0191）。CD68⁺ TAM数量与HCC患者的年龄、性别无关（P>0.05），而与HCC病理分级有关（P=2.83E-04）。血清AFP水平与HCC患者的年龄、性别、病理分级无关（P>0.05）。CD68⁺ TAM高密度组的总生存时间显著短于低密度组（P=0.0004）。而AFP高水平组与低水平组比较，总生存时间、Ki-67阳性率差异均无统计学意义（P>0.05）。结论 HCC患者肝癌组织中CD68⁺ TAM数量与肝癌增殖活性密切相关，是HCC预后的独立危险因素。与AFP相比，CD68⁺ TAM有望成为评估肝癌预后更可靠的指标。

Correlation of CD68+ Tumor-associated Macrophages Number with Ki-67 Expression and Prognosis of Patients with Primary Hepatocellular Carcinoma

Objective To determine a reliable prognostic marker for hepatocellular carcinoma(HCC), we investigated the prognostic significance of the relationship between the number of CD68⁺ tumor-associated macrophages(TAM) and Ki-67. Methods SABC immunohistochemistry was used to observe the distribution of TAM marker CD68⁺ and the protein expression of proliferation index Ki-67 in HCC tissues from 73 patients who had complete histories and were followed up for more than five years. AFP in those patients’ serums was detected by chemiluminescent immunoassay(CLIA). Results The positive rate of Ki-67 was significantly higher in CD68⁺ high-density group, compared with CD68⁺ low-density group (P=0.0191). There was no correlation between the number of CD68+ TAM and age, gender(P>0.05). The number of CD68⁺ TAM was correlated positively with histological grade(P=2.83E-04). However, no correlation between the serum AFP level and age, gender or histological grade was observed(P>0.05). The overall survival (OS) in high CD68⁺ TAM group was significantly shorter than that in low CD68⁺ TAM group (P=0.0004). Nevertheless, no statistical significance was found in OS or Ki-67 positive rate between high AFP and low AFP group (P>0.05). Conclusion CD68⁺ TAM number is closely correlated with HCC proliferation activity and is an independent risk factor for HCC prognosis. Compared with AFP, CD68+ TAM might serve as a prognostic marker for HCC.