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目的探讨原发性肝细胞癌组织中甲胎蛋白(AFP)表达与肝祖细胞激活状态及患者预后的关系。方法回顾性分析92例接受根治性切除术的原发性肝癌患者资料。其中男性76例,女性16例;年龄25~72岁,中位年龄51岁。对手术病理标本进行AFP和细胞角蛋白19(CK19)染色观察并定量。采用单因素Kaplan-Meier生存分析,观察AFP的表达对术后生存时间的影响。Cochran-Armitage线性趋势检验分析祖细胞激活状态(CK19阳性染色)评分与AFP表达的相关性。结果肝癌组织AFP高表达组总生存期短于肝癌组织AFP低表达组(P=0.021)。祖细胞激活状态评分与血清AFP浓度(P=0.046)、肝癌组织AFP表达(P<0.001)正相关。结论肝细胞癌甲胎蛋白高表达对肝癌预后不利,可能与肝脏祖细胞的激活状态有关。
Objective To investigate the relationship between the expression of AFP and the activation of hepatic progenitor cells and the prognosis in primary hepatocellular carcinoma. Methods The data of 92 patients with primary liver cancer undergoing radical resection were retrospectively analyzed. 76 males and 16 females, aged from 25 to 72 years, with a median age of 51 years. The pathological specimens of AFP and cytokeratin 19 (CK19) staining were observed and quantified. Single-factor Kaplan-Meier survival analysis was performed to observe the effect of AFP expression on postoperative survival time. Cochran-Armitage linear trend test was used to analyze the correlation between progenitor cell activation status (CK19 positive staining) and AFP expression. Results The overall survival of HCC tissues with AFP high expression group was shorter than that of HCC AFP low expression group (P = 0.021). The activation score of progenitor cells was positively correlated with serum AFP concentration (P = 0.046) and AFP expression in hepatocellular carcinoma (P <0.001). Conclusion The high expression of alpha-fetoprotein in hepatocellular carcinoma is unfavorable to the prognosis of hepatocellular carcinoma, which may be related to the activation of hepatic progenitor cells.