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肝细胞生长因子和c-met对肝细胞癌患者的预后价值研究

[Study on the prognostic value of hepatocyte growth factor and c-met for patients with hepatocellular carcinoma].

作者信息

Wu Fu-sheng, Zheng Shu-sen, Wu Ling-jiao, Ding Wei, Ma Zhi-min, Wang Zhao-ming, Teng Li-song, Zhao Wen-he

机构信息

Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2006 May 1;44(9):603-8.

Abstract

OBJECTIVE

To analyze the prognostic value of hepatocyte growth factor (HGF) and c-met for patients with hepatocellular carcinoma (HCC) after hepatectomy.

METHODS

Twenty-five patients undergoing partial hepatectomy for HCC were studied. Serum HGF level was determined using ELISA kit before and after operation respectively. c-met protein and mRNA expression in cancerous and paracancerous tissues were detected by immunohistochemical and RT-PCR methods respectively. The correlations of clinical-pathologic parameters with the HGF level in serum and c-met expression in cancerous tissue were analyzed respectively.

RESULTS

HCC patients had a significantly higher concentration of serum HGF than normal controls and chronic hepatitis B respectively [(1.03 +/- 0.09) ng/ml vs (0.69 +/- 0.02) ng/ml and (0.74 +/- 0.09) ng/ml]. No significant difference in serum HGF was observed between HCC and cirrhosis patients with Child-Pugh score B/C [(1.03 +/- 0.09) ng/ml vs (1.04 +/- 0.11) ng/ml]. Serum HGF concentrations were positively correlated with tumor size (> 5 cm), node cirrhosis, portal vein tumor thrombi (PVTT) and preoperative alpha-fetoprotein (AFP) level (> or = 400 microg/L). After the resection of tumor, serum HGF concentration had a peak on the third postoperative day (POD), and then declined, but did not return to normal level on the tenth POD. From preoperative day to third POD, HGF concentration had a higher elevation in patients with major resection than with local resection. Moderately or strongly positive expression of c-met protein was observed in 21 cancerous regions (21/25), and only in 5 paracancerous regions. The intensive expression of c-met mRNA was 100% (25/25) detectable in the cancerous tissues, but only 24% (6/25) in the paracancerous tissues. The expression extent of c-met protein was correlated with portal vein tumor thrombi (PVTT). In paracancerous tissues, the expression of c-met protein was more intense in patients with cirrhosis than those without cirrhosis. The patients with recurrence or metastases after operation had a higher level of serum HGF and more intensive expression of c-met than other patients. No significant association was observed between HGF in serum and c-met expression in cancerous tissue.

CONCLUSIONS

The over-expression of HGF and its receptor c-met indicate an adverse prognosis for HCC patients. The sustained high level of serum HGF after hepatectomy may be a factor related to early tumor recurrence and metastasis.

摘要

目的

分析肝细胞生长因子(HGF)及c-met对肝癌(HCC)患者肝切除术后的预后价值。

方法

对25例行肝癌部分肝切除术的患者进行研究。分别于术前及术后采用ELISA试剂盒测定血清HGF水平。分别采用免疫组化和RT-PCR方法检测癌组织及癌旁组织中c-met蛋白及mRNA表达。分别分析临床病理参数与血清HGF水平及癌组织中c-met表达的相关性。

结果

肝癌患者血清HGF浓度显著高于正常对照组及慢性乙型肝炎患者[(1.03±0.09)ng/ml对(0.69±0.02)ng/ml及(0.74±0.09)ng/ml]。肝癌患者与Child-Pugh评分B/C级的肝硬化患者血清HGF水平无显著差异[(1.03±0.09)ng/ml对(1.04±0.11)ng/ml]。血清HGF浓度与肿瘤大小(>5cm)、结节性肝硬化、门静脉癌栓(PVTT)及术前甲胎蛋白(AFP)水平(>或=400μg/L)呈正相关。肿瘤切除后,血清HGF浓度于术后第3天(POD)达到峰值,随后下降,但在术后第10天未恢复至正常水平。从术前到术后第3天,大切除患者的HGF浓度升高幅度高于局部切除患者。21个癌组织区域(21/25)观察到c-met蛋白中度或强阳性表达,而癌旁组织中仅5个区域有此表达。癌组织中c-met mRNA的强表达100%(25/25)可检测到,而癌旁组织中仅24%(6/25)可检测到。c-met蛋白的表达程度与门静脉癌栓(PVTT)相关。在癌旁组织中,肝硬化患者的c-met蛋白表达比无肝硬化患者更强烈。术后复发或转移患者的血清HGF水平更高,c-met表达更强。血清HGF与癌组织中c-met表达之间未观察到显著相关性。

结论

HGF及其受体c-met的过表达提示肝癌患者预后不良。肝切除术后血清HGF持续高水平可能是早期肿瘤复发和转移的相关因素。

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