乙肝相关性肝癌组织中p27、p53及增殖细胞核抗原的表达

目的探讨乙肝相关性肝细胞癌组织中p27、p53与增殖细胞核抗原（proliferating cell nuclear antigen，PCNA）的表达及其临床病理学意义。方法通过免疫组化法检测40例乙肝相关性肝细胞肝癌组织及其相应的癌旁组织中p27、p53与PCNA的表达。结果（1）p53蛋白在肝癌组织中阳性表达率明显高于癌旁肝组织（P=0.047），低分化肝癌组织中p53阳性表达率明显高于高中分化者（P=0．017）。（2）肝癌组织中p27蛋白染色指数明显低于癌旁肝组织（P=0．045），在肿瘤直径〉5cm（P=0．031）与存在肝外转移的肝癌组织中进一步降低（P=0．028）。（3）肝癌组织中PCNA染色指数明显高于癌旁肝组织（P=0.029）。在肿瘤直径〉5cm（P=0．037）与包膜侵犯的肝癌组织中进一步增高（P=0．035）。（4）Cox比例风险模型多因素分析发现临床分期（P=0．028）为独立的预后因子。结论细胞周期调控因子p53、p27与PCNA的异常表达与乙肝相关性肝细胞癌的分化、浸润及转移有着密切的联系。

Expression and significance of p27, p53 and PCNA in hepatitis B virus-associated hepatocellular carcinoma

Objective To investigate the expression and significance of cell cycle regulator genes p27, p53 and proliferating cell nuclear antigen(PCNA) in hepatitis B virus associated hepatocellular carcinoma. Methods p27,p53 and PCNA expression in 40 hepatitis B virus associated hepatocellular tumoral and adjacent non-tumoral livers were measured by immunohistochemisty(IHC). Results (1 )The positive rate of p53 expression was significantly higher in HCC than that in the adjacent non-tumoral liver rissues(.P =0.047).There was positivecorrelation between the aberrant expression of p53 protein and poorer histological grade of differentiation( P=0. 017). (2)p27 LI in tumoral livers was significantly lower than that in adjacent non-tumoral liver tissues(P=0.045). p27 LI was significantly decreased in cases with tumor diameter>5cm(P = 0. 031) and extra hepatic metastasis(P = 0. 028). (3) PCNA LI in tumoral livers was significantly higher than that in adjacent non-tumoral liver tissues( P = 0.029). PCNA LI was significantly increased in cases with tumor diameter >5cm(P =0. 037) and capsular infiltration(P = 0.035). (4)Cox proportional hazard regression analyses showed clinical stage(P = 0.037) was an independent prognosis marker. Conclusion Aberrant expression of cell cycle regulator genes p27,p53 and PCNA in hepatitis B virus associated hepatocellular carcinoma is closely associated with differentiation, infiltration and metastasis.