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目的:探讨生物学标记物对预测肝癌移植术后复发的价值。方法:回顾性分析2002年4月至2005年11月50例肝癌移植病例,存活者至少随访12月,石蜡切片做免疫组化检测E-cadherin、β-catenin、Ki-67的表达,分析其与复发、生存时间的相关性并与一些主要临床病理指标进行比较。结果:TNM分期、门静脉癌栓仅在单变量分析中对预测复发、生存时间有意义(P<0.05),术前血清AFP仅在多变量分析中与复发有关(OR=2.552,P<0.05);胞膜E-cadherin低表达、核β-catenin阳性、核Ki-67高增殖指数在单变量分析中对预测复发、生存时间的统计学意义均显著,而且在多变量分析中结果类似(均P<0.01),但胞膜β-catenin表达和预后无关(P>0.05)。结论:这3个生物学标记物有前景成为肝癌移植术后复发的预后因子,且价值可能优于临床病理指标。
Objective: To investigate the value of biomarkers in predicting recurrence after liver cancer transplantation. Methods: 50 HCC cases from April 2002 to November 2005 were retrospectively analyzed. Survivors were followed up for at least 12 months. The expression of E-cadherin, β-catenin and Ki-67 were detected by immunohistochemistry in paraffin sections. Relapse, survival time and with some of the major clinical and pathological indicators were compared. Results: The TNM staging and portal vein tumor thrombus were only significant predictors of recurrence and survival time in univariate analysis (P <0.05). Preoperative serum AFP was only associated with recurrence in multivariate analysis (OR = 2.552, P <0.05) ; The low expression of E-cadherin in cell membrane and the positive expression of nuclear β-catenin, nuclear Ki-67 high proliferation index in predicting recurrence and survival time in univariate analysis were all significant, and the results were similar in multivariate analysis P <0.01), but there was no correlation between the expression of β-catenin and prognosis (P> 0.05). Conclusion: The three biomarkers have the potential to be prognostic factors for recurrence of liver cancer after transplantation, and the value may be superior to clinicopathological parameters.