| 摘要: |
| 目的 探讨肝细胞癌（HCC）患者肝癌组织和癌旁组织中羧基末端截短型乙型肝炎病毒X蛋白（Ct-HBx）的表达及其与患者术后预后的关系。方法 采用免疫组织化学染色法检测462例肝癌组织、配对的263例癌旁组织和配对的25例癌栓组织中Ct-HBx蛋白的表达，分析其与临床病理参数的关系，探讨Ct-HBx蛋白的表达与HCC患者术后预后的关系。结果 Ct-HBx蛋白表达在配对的263例肝癌组织和癌旁组织中阳性率分别为43.73%（115/263）和11.79%（31/263）；多因素Cox风险回归模型分析结果显示年龄、门静脉癌栓（PVTT）、术前天冬氨酸转氨酶（AST）、术前甲胎蛋白（AFP）、主瘤旁微小子灶、术前巴塞罗那临床肿瘤（BCLC）分期和术后抗病毒治疗是HCC患者术后复发的独立危险因素（P均<0.05），门静脉癌栓、术前AFP、肿瘤包膜、术前BCLC分期和Ct-HBx蛋白表达是HCC患者术后生存的独立危险因素（P均<0.05）。在263对配对样本中，肝癌组织中Ct-HBx蛋白的表达与性别、糖类抗原19-9（CA19-9）、术后抗病毒治疗有关（P均<0.05）。肝癌组织和癌旁组织中Ct-HBx蛋白均为阴性表达的患者术后3年无瘤生存率高于Ct-HBx蛋白在肝癌组织阴性表达且在癌旁组织阳性表达的患者（P=0.050 1）。结论 当HCC患者肝癌组织中Ct-HBx蛋白表达呈阴性时，癌旁组织中Ct-HBx蛋白的表达情况可能与术后预后有关，可作为预测术后肿瘤生存和复发的标志物。 |
| 关键词: 肝肿瘤 肝细胞癌 乙型肝炎病毒 羧基末端截短型乙型肝炎病毒X蛋白 存活率分析 预后 |
| DOI：10.16781/j.0258-879x.2019.02.0125 |
| 投稿时间：2018-11-14修订日期：2019-01-27 |
| 基金项目:国家重点基础研究发展计划（2015CB554005），国家自然科学基金（81373067，81502882）. |
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| Expression of carboxylic acid-terminal truncated hepatitis B virus X protein in hepatocellular carcinoma and adjacent tissues and its effect on postoperative prognosis |
| ZHONG Xiao-yi1△,MA Long-teng1△,CHEN Xi1,WU Ting1,LI Nan2,CAO Guang-wen1,YIN Jian-hua1* |
(1. Department of Epidemiology, Faculty of Naval Medicine, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Hepatic Surgery(Ⅵ), Eastern Hepatobiliary Surgery Hospital, Naval Medical University(Second Military Medical University), Shanghai 200438, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To determine the expression of carboxylic acid-terminal truncated hepatitis B virus X protein (Ct-HBx) in hepatocellular carcinoma (HCC) tissues and corresponding adjacent non-tumor tissues, and to explore its effect on postoperative prognosis of HCC patients. Methods Immunohistochemistry was performed to measure the expression levels of Ct-HBx in 462 HCC tissues, 263 matched adjacent tissues and 25 matched tumor thrombus tissues. The relationships between Ct-HBx expression and clinicopathological data and postoperative prognosis of HCC patients was analyzed. Results The positive rates of Ct-HBx in 263 HCC and paired adjacent tissues were 43.73% (115/263) and 11.79% (31/263), respectively. Multivariate Cox regression analysis showed that age, portal vein cancer thrombus (PVTT), preoperative aspartate aminotransferase (AST), preoperative α-fetoprotein (AFP), small daughter nodule, preoperative Barcelona Clinic Liver Cancer (BCLC) stage and postoperative antiviral treatment were independent risk factors of postoperative recurrence of HCC patients (all P<0.05), and the PVTT, preoperative AFP, tumor encapsulation, preoperative BCLC stage and Ct-HBx protein expression were independent risk factors for postoperative survival of HCC patients (all P<0.05). Analysis results of 263 paired HCC and adjacent tissues showed that the expression of Ct-HBx in the HCC tissues was related to gender, carbohydrate antigen 19-9 (CA19-9) and postoperative antiviral treatment (all P<0.05). Compared with the patients with negative Ct-HBx in HCC tissues and positive Ct-HBx in adjacent tissues, the patients with negative Ct-HBx in both HCC and adjacent no-tumor tissues had significantly higher 3-year disease free survival rate (P=0.050 1). Conclusion For HCC patients with negative expression of Ct-HBx in HCC tissues, the expression level of Ct-HBx in corresponding adjacent no-tumor tissues is related to the postoperative prognosis of HCC patients, and it may be a potential molecular biomarker to predict postoperative survival and recurrence. |
| Key words: liver neoplasms hepatocellular carcinoma hepatitis B virus carboxylic acid-terminal truncated hepatitis B virus X protein survival analysis prognosis |
