Liu Yingbin, Chen Xiaopeng, Peng Shuyou, Fang Heqing, Wu Yulian, Peng Chenhong, Shi Liubin, Bai Mingdong, Xu Bin, Wang Jianwei, Deng Guilong
Department of Surgery, Second Affiliated Hospital, Medical School of Zhejiang University, Hangzhou 310009, China.
Zhonghua Yi Xue Za Zhi. 2002 Nov 25;82(22):1553-6.
To explore the relation between heparanase (HPA) and nm23-H1 in hepatocellular carcinoma (HCC), and judge whether they may be used as valuable markers in predicting postoperative metastasis and recurrence of HCC.
Reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry (S-P method) were used to measure the expressions of the HPA mRNA and nm23-H1 protein in the primary tumor tissue and paracancer tissue of 33 cases of HCC. The paracancer tissues of 9 cases of benign liver tumor were used as normal controls. The results were analyzed in combination with the results of clinicopathological examination and follow-up.
The expression of HPA gene was positive in 16 cases of primary tumor tissues of HCC with a positive rate of 48.5%, significantly higher than those in paracancer tissues of HCC cases and in normal controls (P < 0.01). The HPA expression was not related with the size of tumor, envelope formation, AFP level, HBsAg state and cirrhosis of liver. The positive rates of HPA mRNA in the group with high tendency to metastasis or recurrence and the group with metastasis or recurrence during follow-up were significantly higher than that in the group with low tendency to metastasis or recurrence group (P < 0.05) and that in the group without metastasis or recurrence (P < 0.01). The poorly differentiated tumor and tumor of TNM stage III-IV had higher positive rates of HPA gene expression than the well-mediate differentiated tumor and tumor of TNM stage I-II (P < 0.05). The positive expression rates of nm23-Hl protein in HCC tissue was significantly lower than that in corresponding non-cancerous or normal liver tissue (P < 0.05). nm23-Hl expression was not related with the size of tumor, envelope formation, AFP level, HBsAg state, cirrhosis of liver, Edmondson grade, and TNM stage (P > 0.05). The positive rate of nm23-Hl in the group with high tendency to metastasis and recurrence and in patients with metastasis or recurrence during follow-up was obviously higher than that in the group with low tendency to metastasis and recurrence (P = 0.018) and that in the patients without metastasis and recurrence (P = 0.024), but no significant difference was found between HPA positive and negative groups (P = 0.082). According to the results of follow-up, the rates of accuracy in predicting metastasis of positive HPA, negative nm23-H1 and combination of positive HPA with negative nm23-H1 were 78.6% (11/14), 68.8% (11/16) and 88.9% (8/9) respectively.
Expression of HPA and/or nm23-Hl are related with metastasis and recurrence of HCC. Combining the expression rate of HPA with the expression rate of nm23-H1 may increase the accuracy in predicting HCC postoperative metastasis and recurrence.
探讨乙酰肝素酶（HPA）与nm23-H1在肝细胞癌（HCC）中的关系，并判断它们是否可作为预测HCC术后转移和复发的有价值指标。
采用逆转录聚合酶链反应（RT-PCR）和免疫组织化学（S-P法）检测33例HCC患者原发肿瘤组织及癌旁组织中HPA mRNA和nm23-H1蛋白的表达。9例良性肝肿瘤的癌旁组织作为正常对照。结合临床病理检查及随访结果进行分析。
16例HCC原发肿瘤组织中HPA基因表达阳性，阳性率为48.5%，显著高于HCC病例的癌旁组织及正常对照（P<0.01）。HPA表达与肿瘤大小、包膜形成、甲胎蛋白水平、乙肝表面抗原状态及肝硬化无关。转移或复发倾向高的组及随访期间发生转移或复发的组中HPA mRNA阳性率显著高于转移或复发倾向低的组（P<0.05）及无转移或复发的组（P<0.01）。低分化肿瘤及TNM分期III-IV期的肿瘤HPA基因表达阳性率高于高分化肿瘤及TNM分期I-II期的肿瘤（P<0.05）。HCC组织中nm23-Hl蛋白阳性表达率显著低于相应的癌旁或正常肝组织（P<0.05）。nm23-Hl表达与肿瘤大小、包膜形成、甲胎蛋白水平、乙肝表面抗原状态、肝硬化、Edmondson分级及TNM分期无关（P>0.05）。转移和复发倾向高的组及随访期间发生转移或复发的患者中nm23-Hl阳性率明显高于转移和复发倾向低的组（P=0.018）及无转移和复发的患者（P=0.024），但HPA阳性和阴性组之间无显著差异（P=0.082）。根据随访结果，HPA阳性、nm23-H1阴性及HPA阳性与nm23-H1阴性联合预测转移的准确率分别为78.6%（11/14）、68.8%（11/16）和88.9%（8/9）。
HPA和/或nm23-Hl的表达与HCC的转移和复发有关。联合HPA表达率与nm23-H1表达率可提高预测HCC术后转移和复发的准确率。
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