生物学标记物应用于肝癌原位肝移植预后的研究

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。

Prognostic role of biomarkers applied to hepatocellular carcinoma patients treated with orthotopic liver transplantation

AIM:To investigate the prognostic value of biomarkers on predicting recurrence of hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT). METHODS:Fifty patients with HCC who underwent OLT between April 2002 and November 2005 with a minimum clinical follow up of 12 months were included in this retrospective study. We examined immunohistochemical expression of E-cadherin with β-catenin, Ki-67 proliferative index and analyzed the correlation between these biomarkers with recurrence and survival, along with the main clinical-pathological variables.RESULTS:Only at univariate analysis, TNM, portal vein tumor thrombi were valuable on predicting recurrence and survival time (P<0.05), and preoperative serum AFP correlate to recurrence only at multivariate analysis (OR=2.552, P<0.05). Lower membrane expression of E-cadherin, nuclear β-catenin localization and high Ki-67 index showed notable significance on predicting recurrence and survival time at univariate analysis, as well at multivariate analysis, all P<0.01. The membrane expression of β-catenin did not correlate to the prognosis (P>0.05).CONCLUSION:These three biomarkers might have potential as a tumor prognostic marker for predicting recurrence of HCC after OLT and perhaps are better than the clinical-pathological variables.