Relationship between expression level of 15-PGDH and clinical prognosis of liver transplantation for hepatocellular carcinoma
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摘要:
目的 探讨15-羟基前列腺素脱氢酶(15-PGDH)表达水平与肝细胞癌(肝癌)肝移植临床预后的关系。 方法 回顾性分析行肝癌肝移植术的94例受者临床资料。用免疫组织化学法检测所有受者病理组织切片中15-PGDH表达情况;分析15-PGDH蛋白表达水平与肝癌患者各项临床参数的关系;计算肝癌肝移植受者术后5年的无瘤生存率和总生存率;分析可能影响肝癌肝移植受者预后的独立危险因素。 结果 15-PGDH的表达水平与受者的年龄、Child-Pugh分级和术前甲胎蛋白(AFP)水平相关(均为P < 0.05)。15-PGDH低表达组受者的无瘤生存率和总生存率均显著低于15-PGDH高表达组受者(均为P < 0.05)。15-PGDH表达水平、肿瘤分化程度、美国癌症联合会(AJCC)分期是影响肝癌肝移植受者预后的独立危险因素(均为P < 0.05)。 结论 15-PGDH表达水平是影响肝癌肝移植受者预后的独立危险因素。 Abstract:Objective To investigate the relationship between the expression level of 15-hydroxyprostaglandin dehydrogenase (15-PGDH) and clinical prognosis of liver transplantation for hepatocellular carcinoma. Methods The clinical data of 94 recipients undergoing liver transplantation for hepatocellular carcinoma were retrospectively analyzed. The expression of 15-PGDH in the pathological tissues of all recipients was detected by immunohistochemical staining. The relationship between the expression level of 15-PGDH protein and clinical parameters of hepatocellular carcinoma patients was analyzed. The 5-year tumor-free survival and overall survival rates of liver transplant recipients were calculated. The possible independent risk factors of the clinical prognosis of liver transplant recipients were analyzed. Results The expression level of 15-PGDH was significantly correlated with age, Child-Pugh grade and preoperative level of alpha-fetoprotein (AFP) of the recipients (all P < 0.05). The tumor-free survival and overall survival rates of the recipients with low expression of 15-PGDH were significantly lower than those in their counterparts with high expression of 15-PGDH (both P < 0.05). The expression level of 15-PGDH, degree of tumor differentiation and American Joint Committee on Cancer (AJCC) staging were the independent risk factors of clinical prognosis of liver transplantation for hepatocellular carcinoma (all P < 0.05). Conclusions The expression level of 15-PGDH is an independent risk factor of clinical prognosis of liver transplantation for hepatocellular carcinoma. -
表 1 15-PGDH与肝癌肝移植受者各项临床参数的相关性
Table 1. Correlation between 15-PGDH and clinical parameters of liver transplant recipients with hepatocellular carcinoma[n(%)]
临床参数 15-PGDH表达水平 P值 低表达组
(n=54)高表达组
(n=40)性别 0.637 男 50(93) 38(95) 女 4(7) 2(5) 年龄 0.013 ≥50岁 38(70) 18(45) < 50岁 16(30) 22(55) 肿瘤数目 0.095 1个 23(43) 24(60) ≥2个 31(57) 16(40) 术前AFP水平 0.027 ≤400 μg/L 24(44) 27(68) > 400 μg/L 30(56) 13(32) Child-Pugh分级 0.028 A 30(56) 30(75) B 20(37) 5(13) C 4(7) 5(13) AJCC分期 0.170 Ⅰ 10(19) 14(35) Ⅱ 11(20) 8(20) Ⅲ 33(61) 18(45) 肿瘤大小 0.05 < 5 cm 20(37) 25(63) 5~8 cm 11(20) 5(13) > 8 cm 23(43) 10(25) 分化程度 0.295 高 13(24) 12(30) 中 33(61) 26(65) 低 8(15) 2(5) 大血管侵犯 0.09 有 27(50) 13(33) 无 27(50) 27(68) 米兰标准 0.294 符合 16(30) 16(40) 不符合 38(70) 24(60) 乙型或丙型病毒性肝炎标志物 0.219 阳性 52(96) 40(100) 阴性 2(4) 0(0) 表 2 肝癌肝移植受者预后的危险因素分析
Table 2. Analysis of risk factors for prognosis of liver transplant recipients with hepatocellular carcinoma
变量 单因素分析 多因素分析 HR① 95%CI② P值 HR 95%CI P值 15-PGDH 0.419 0.233~0.753 0.004 0.445 0.246~0.804 0.007 年龄 0.542 0.305~0.964 0.037 — — 0.446 Child-Pugh分级 1.446 1.014~2.063 0.042 — — 0.666 分化程度 2.513 1.532~4.122 < 0.001 2.549 1.551~4.187 < 0.001 AJCC分期 2.222 1.497~3.298 < 0.001 2.137 1.454~3.140 < 0.001 大血管侵犯 2.991 1.729~5.175 < 0.001 — — 0.609 术前AFP水平 2.402 1.389~4.153 0.002 — — 0.137 肿瘤大小 1.698 1.268~2.275 < 0.001 — — 0.308 注:①HR为风险比。
②CI为可信区间。 -
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