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中华普通外科学文献(电子版)

中华普通外科学文献(电子版) ›› 2015, Vol. 09 ›› Issue (04) : 291 -295. doi: 10.3877/cma.j.issn.1674-0793.2015.04.009

所属专题： 文献；

论著

肝癌衍生生长因子在原发性肝内胆管细胞癌中的表达及其临床意义
何坤1, 阮嘉后1, 储兵1, 周载平1, 黄锐钦1, 胡泽民1,†()   
  1. 1. 528400　中山市人民医院肝胆外科
  • 收稿日期:2015-03-07 出版日期:2015-08-01
  • 通信作者: 胡泽民
  • 基金资助:
    中山市科技局立项课题(20122A094)

Expression and clinical value for hepatoma-derived growth factor in primary intrahepatic cholangiocarcinoma

Kun He1, Jiahou Ruan1, Bing Chu1, Zaiping Zhou1, Ruiqin Huang1, Zeming Hu1,†()   

  1. 1. Department of Hepatobiliary Surgery, Zhongshan People's Hospital, the Affiliated Hospital of Sun Yat-sen University, Zhongshan 528400, China
  • Received:2015-03-07 Published:2015-08-01
  • Corresponding author: Zeming Hu
  • About author:
    Corresponding author: Hu Zeming, Email:
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引用本文：

何坤, 阮嘉后, 储兵, 周载平, 黄锐钦, 胡泽民. 肝癌衍生生长因子在原发性肝内胆管细胞癌中的表达及其临床意义[J/OL]. 中华普通外科学文献(电子版), 2015, 09(04): 291-295.

Kun He, Jiahou Ruan, Bing Chu, Zaiping Zhou, Ruiqin Huang, Zeming Hu. Expression and clinical value for hepatoma-derived growth factor in primary intrahepatic cholangiocarcinoma[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2015, 09(04): 291-295.

目的

探讨肝癌衍生生长因子(HDGF)与原发性肝内胆管细胞癌(PICC)预后的关系。

方法

选择2011年1月至2014年12月共55例肝内胆管细胞癌手术标本和30例非癌变标本,进行免疫组织化学(IHC)染色及评估、全RNA提取、逆转录PCR(RT-PCR)以及结果判定。

结果

特异性HDGF染色主要存在于良性和恶性上皮细胞的细胞核和细胞质中。52.7%(29/55)的PICC提示细胞核HDGF EI 2级。对比之下,非癌变标本的细胞核HDGF蛋白表达EI 2级率是33.3%(10/30)。核HDGF表达与PICC的T分类、N分类和肿瘤分化密切相关(P<0.01)。Log-rank检验显示,在PICC中高HDGF表达组生存期短,而低HDGF表达组生存期长。

结论

PICC中核HDGF水平升高,并与PICC的TNM分期、肿瘤分化、PICC的生存期有关。HDGF可能是PICC预后的独立预测因素。

关键词: 肝癌衍生生长因子, 原发性肝内胆管细胞癌, 预后, 独立预测因素
Objective

To analyze the relationship between hepatoma-derived growth factor(HDGF) and intrahepatic cholangiocarcinoma (PICC).

Methods

The data of fifty-five cases of PICC operation specimens and 30 cases of noncancerous specimens from January 2011 to December 2014 were collected. All the specimens were detected by immunohistochemistry (IHC) staining and evaluation, total RNA extraction, reverse transcription PCR (RT-PCR).

Results

Specific HDGF dyeing mainly existed in nucleus and cytoplasm of benign and malignant epithelial cells. 52.7% (29/55) PICC biopsy suggested nuclei HDGF EI level 2. In contrast, 33.3% (10/30) in noncancerous specimens got EI level 2. Nucleus PICC was closely related to T classification, N classification and tumor differentiation (P<0.01). Log-rank test showed that survival period of PICC in high HDGF expression group was shorter than in low HDGF group.

Conclusion

Nucleus HDGF level rises in PICC patients, which is related with TNM stage, tumor differentiation, and PICC survival period. HDGF may be an independent predictor for PICC prognosis.

Key words: Hepatoma-derived growth factor, Primary intrahepatic cholangiocarcinoma, Prognosis, Independent predictor
图1 PICC和正常肝内胆管组织标本中HDGF蛋白表达（DAB染色，×400）PICC组织标本中HDGF蛋白表达（A），PICC标本中HDGF表达3分（B），PICC标本中HDGF表达1分（C），正常肝内胆管组织中HDGF表达阴性（D）
表1 PICC的临床病理特点和HDGF蛋白表达的关系[例(%)]
临床特征 例数 HDGF (分) χ2值 P值
3 1~2
性别 ? ? ? 0.003 0.959
? 男 9 6(66.7) 3(33.3) ? ?
? 女 46 31(67.4) 15(32.6) ? ?
抽烟 ? ? ? 0.021 0.885
? 是 33 22(66.7) 11(33.3) ? ?
? 否 22 15(68.2) 7(31.8) ? ?
喝酒 ? ? ? 3.953 0.057
? 是 22 12(54.5) 10(45.5) ? ?
? 否 33 25(75.8) 8(24.2) ? ?
肝内胆管结石史 ? ? ? 2.414 0.120
? 是 37 27(73.0) 10(27.0) ? ?
? 否 18 10(55.6) 8(44.4) ? ?
乙肝病毒阳性 ? ? ? 0.956 0.328
? 是 39 25(64.1) 14(35.9) ? ?
? 否 16 12(75.0) 4(25.0) ? ?
T分类 ? ? ? 7.016 0.008 a
? T1-T2 39 23(59.0) 16(41.0) ? ?
? T3-T4 16 14(87.5) 2(12.5) ? ?
N分类 ? ? ? 15.147 0.000 a
? N0-N1 26 12(46.2) 14(53.8) ? ?
? N2-N3 29 25(86.2) 4(13.8) ? ?
远处转移 ? ? ? 0.045 0.832
? 是 13 9(69.2) 4(30.8) ? ?
? 否 42 28(66.7) 14(33.3) ? ?
肿瘤分化 ? ? ? 6.031 0.014 a
? 高 11 0(0) 11(100.0) ? ?
? 中 32 25(78.1) 7(21.9) ? ?
? 低 12 12(100.0) 0(0) ? ?
图2 55例PICC患者HDGF蛋白不同表达组的总体生存时间比较
表2 单变量和多变量Cox回归分析预后影响因素
参数 单变量分析 多变量分析
P值 HR 95% CI 回归系数 标准误 P值 风险度 95% CI
年龄(≥ 50 ∶ < 50岁) 0.321 1.219 0.825~1.801 ? ? ? ? ?
性别(男∶女) 0.310 1.229 0.826~1.829 ? ? ? ? ?
吸烟(是∶否) 0.784 1.059 0.701~1.601 ? ? ? ? ?
喝酒(是∶否) 0.468 0.861 0.574~1.291 ? ? ? ? ?
HBV感染(是∶否) 0.866 1.040 0.661~1.634 ? ? ? ? ?
T分类(T3-T4 ∶ T1-T2) 0.390 1.202 0.790~1.828 ? ? ? ? ?
N分类(N2-N3 ∶ N0-N1) 0.028 1.557 1.048~2.314 2.758 1.395 0.267 0.722 0.406~1.283
M分类(M0∶M1) 0.170 0.731 0.468~1.143 ? ? ? ? ?
肿瘤分化(高∶中、低) 0.041 1.526 1.017~2.290 2.162 1.226 0.335 1.443 0.684~3.044
HDGF表达指数(EI)(II ∶I) 0.000 2.316 1.548~3.464 3.857 0.773 0.000 0.358 0.210~0.610
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