原发性肝细胞癌组织中P21的亚细胞定位及其意义

目的探讨原发性肝细胞癌组织中P21的亚细胞定位及其意义。方法收集115例由肝硬化发展成肝癌的病理标本，包括同一病例的肝癌组织、癌旁组织、肝硬化组织。采用SP法分别行P21的免疫组织化学染色，观察P21的亚细胞分布，并对其与肝癌的临床病理特征、癌细胞分化程度进行相关性分析。结果HCC组和癌旁组均有P21的高表达（35．65％，38．26％），两者之间的差异无统计学意义（P〉0．05），但明显高于肝硬化组（10．43％，P〈0．01）。P21胞质表达的阳性率，肝硬化组与癌旁组相近（8．33％，6．82％，P〉0．05），而肝癌组胞质表达的阳性率最高（75．61％，P〈0．01）。P21的亚细胞定位分布与肝癌患者的发病年龄、乙肝病毒的感染、肿瘤大小无明显相关性（P〉0．01或0．05），但与肿瘤细胞的病理分级、肿瘤转移具有良好的相关性。Ⅲ-Ⅳ级、伴有肿瘤转移的肝癌患者，其P21的胞质表达率更高。结论在肝硬化向肝癌转化的过程中，伴有P21亚细胞定位的改变，即由胞核移位到胞质，且肿瘤细胞恶性程度愈高，肿瘤转移愈早，胞质移位比例愈高。但这种亚细胞定位分布的改变，与肿瘤患者的发病年龄、乙肝病毒的感染、肿瘤大小无关。

Subcellular Localization of P21 in Hepatocellular Carcinoma and its Clinical Significance

Objective To study subcellular localization of P21 in Hepatocellular carcinoma and its clinical significance. Methods 115 specimens of HCC based on liver cirrhosis were examined,including HCC tissues, cirrhosis of liver tissues and paracancerous tissues of the same specimen. Specimens were performed HE staining and the expression of P21 protein was examined by immunohistochemistry （ S-P method）, its subcellular localization was observed and correlation with clinical and pathological features was examined. Results The positive rate of 1＇21 in HCC tissues was similar with that of paracancerous tissues（35.65% vs 38.26 %, P 〉 0.01 ）, and significantly higer than liver tissues of cirrhosis （ 10.43 %, P 〈 0.01 ）. The positive rate in cytoplasm of P21 in cirrhosis tissues was similar with that of paracancerous tissues （8.33 % vs 6.82%, P 〉 0.01 ）, and significantly lower than that in HCC tissues（75.61% ,P 〈0.01 ）. There was a significant positive correlation between the subcellular localization of P21 and the tumor differentiation,metastasis,and the localization of P21 in cytoplasm was no obvious associated with age or HBV infection. Conclusion P21 changes its subcellular localization in the process of transformation from cirrhosis to tumor,namely the shift from the nucleus to the cytoplasm. Higher the degree of malignancy of the tumor cells or earlier the tumor metastasis is, the larger the proportion of cytoplasmic shift has. And changes of subcellular localization, has no association with the age of onset of tumors, hepatitis B virus infection and tumor size.