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目的研究部分凋亡及血管生成因子在肝细胞肝癌(肝癌)中的表达及其临床意义。方法应用免疫组化方法检测90例肝癌标本中p53、Survivin、基质金属蛋白酶(MMP)-2、MMP-9及血管内皮生长因子(VEGF)的表达情况,并分析其与肝癌术后复发的关系。结果p53、Survivin、MMP-2、MMP-9及VEGF的阳性率分别为33·3%、51·1%、60·0%、37·8%及76·7%。经相关性分析,VEGF与MMP-2、VEGF与MMP-9的表达呈正相关;MMP-2、MMP-9及VEGF与术后复发呈正相关(P<0·05)。MMP-2阴性组的1、2、3年无瘤生存率分别显著高于MMP-2阳性组中的相应指标(P<0·05),MMP-9和VEGF中亦发现类似结果。多因素分析发现术前播散结节、镜下微转移灶、血清甲胎蛋白水平以及VEGF和MMP-9的表达水平是肝癌术后复发的独立危险因素。结论p53和Survivin与肝癌术后复发无关;MMPs和VEGF与肝癌术后复发相关,可用于评价术后复发风险。
Objective To study the expression of some apoptosis and angiogenesis factors in hepatocellular carcinoma (HCC) and its clinical significance. Methods The expressions of p53, Survivin, MMP-2, MMP-9 and VEGF in 90 specimens of hepatocellular carcinoma were detected by immunohistochemistry. The relationship between them and recurrence of hepatocellular carcinoma was analyzed . Results The positive rates of p53, Survivin, MMP-2, MMP-9 and VEGF were 33.3%, 51.1%, 60.0%, 37.8% and 76.7% respectively. Correlation analysis showed that there was a positive correlation between the expression of VEGF and MMP-2, VEGF and MMP-9; MMP-2, MMP-9 and VEGF were positively correlated with recurrence (P <0.05). The 1, 2 and 3 year disease-free survival rates in MMP-2 negative group were significantly higher than those in MMP-2 positive group (P <0.05), and similar results were also found in MMP-9 and VEGF. Multivariate analysis showed that preoperative disseminated nodules, microscopic micrometastasis, serum alpha-fetoprotein, and the expression of VEGF and MMP-9 were independent risk factors for postoperative recurrence of liver cancer. Conclusions p53 and Survivin have no relationship with postoperative recurrence of liver cancer. MMPs and VEGF correlate with postoperative recurrence of liver cancer and may be used to evaluate the risk of postoperative recurrence.