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目的:探讨NRAGE在小肝细胞癌中的表达情况及其临床意义。方法:采用免疫组化技术检测160例原发性小肝细胞癌组织及配对癌旁非癌组织中NRAGE的表达,分析NRAGE表达与小肝细胞癌患者临床病理指标及预后的关系。结果:NRAGE在小肝细胞癌组织中阳性表达率明显高于配对癌旁组织(63.13%vs.14.38%,P<0.05)。NRAGE表达增高与患者年龄、术前AFP水平、完整包膜和复发密切相关(均P<0.05)。单因素分析显示,微血管癌栓、术前AFP水平、子灶、完整包膜、复发、浆膜浸润、巴塞罗那分期、分化程度和NRAGE表达是小肝细胞癌患者的预后影响因素(均P<0.05)。多因素分析结果显示,NRAGE表达与微血管癌栓、术前AFP水平、复发、巴塞罗那分期是影响小肝细胞癌患者预后的独立危险因素(均P<0.05)。NRAGE高表达小肝细胞癌患者5年生存率明显低于低表达患者(35.63%vs.54.23%,P<0.05)。结论:NRAGE在小肝细胞癌组织中表达增高,NRAGE高表达患者预后差。
Objective: To investigate the expression of NRAGE in small hepatocellular carcinoma and its clinical significance. Methods: Immunohistochemistry was used to detect the expression of NRAGE in 160 cases of primary small hepatocellular carcinoma (HCC) and matched noncancerous tissues, and to analyze the relationship between NRAGE expression and clinicopathological parameters and prognosis of patients with small hepatocellular carcinoma. Results: The positive expression rate of NRAGE in small hepatocellular carcinoma tissues was significantly higher than that in adjacent tissues (63.13% vs.14.38%, P <0.05). The increased expression of NRAGE was closely related to the age of patients, preoperative AFP level, complete capsule and recurrence (all P <0.05). Univariate analysis showed that the prognostic factors of small hepatocellular carcinoma patients were microvessel thrombolysis, preoperative AFP level, focal lesion, complete capsule, recurrence, serosal invasion, Barcelona staging, differentiation degree and NRAGE expression (all P <0.05 ). Multivariate analysis showed that the expression of NRAGE and microvascular tumor thrombus, preoperative AFP levels, recurrence and Barcelona staging were independent risk factors for prognosis of patients with small hepatocellular carcinoma (all P <0.05). The 5-year survival rate of patients with NRAGE overexpressing small hepatocellular carcinoma was significantly lower than that of patients with low expression (35.63% vs.54.23%, P <0.05). Conclusion: The expression of NRAGE is increased in small hepatocellular carcinoma and the prognosis of patients with high expression of NRAGE is poor.