肝脏血管生成作为丙型肝炎病毒肝硬化患者肝细胞癌发生的一个危险因素。

Liver angiogenesis as a risk factor for hepatocellular carcinoma development in hepatitis C virus cirrhotic patients.

作者信息

Mazzanti Roberto, Messerini Luca, Comin Camilla E, Fedeli Lorenzo, Ganne-Carrie Nathalie, Beaugrand Michel

机构信息

Department of Internal Medicine, University of Florence School of Medicine, Viale GB Morgagni 85, I-50134 Firenze, Italy.

出版信息

World J Gastroenterol. 2007 Oct 7;13(37):5009-14. doi: 10.3748/wjg.v13.i37.5009.

DOI:10.3748/wjg.v13.i37.5009

PMID:17854145

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4434626/

Abstract

AIM

To evaluate the predictive value of hepatocyte proliferation and hepatic angiogenesis for the occurrence of Hepatocellular carcinoma (HCC) in hepatitis C virus (HCV) cirrhotic patients.

METHODS

One hundred-five patients (69 males, 36 females; age range, 51-90 year; median 66 year) with biopsy proven HCV cirrhosis were prospectively monitored for HCC occurrence for a median time of 64 mo. Angiogenesis was assessed by using microvessel density (MVD), hepatocyte turnover by MIB1 and PCNA indexes at inclusion in liver biopsies.

RESULTS

Forty six patients (43.8%) developed HCC after a median time of 55 (6-120) mo while 59 (56.2%) did not. Patients were divided into two groups according to the median value of each index. The difference between patients with low (median MVD = 3; range 0-20) and high (median MVD = 7; range 1-24) MVD was statistically significant (chi(2) = 22.06; P < 0.0001) which was not the case for MIB1 or PCNA (MIB-1: chi(2) = 1.41; P = 0.2351; PCNA: chi(2) = 1.27; P = 0.2589). The median MVD was higher in patients who developed HCC than in those who did not. HCC-free interval was significantly longer in patients with the MVD < or = 4 (P = 0.0006). No relationship was found between MIB1 or PCNA and MVD (MIB-1 r(2) = 0.00007116, P = 0.9281; PCNA: r(2) = 0.001950; P = 0.6692). MVD only was able to predict the occurrence of HCC in these patients. Among other known risk factors for HCC, only male sex was statistically associated with an increased risk.

CONCLUSION

Liver angiogenesis has a role for in HCV-related liver carcinogenesis and for defining patients at higher risk.

摘要

目的

评估肝细胞增殖和肝血管生成对丙型肝炎病毒（HCV）肝硬化患者肝细胞癌（HCC）发生的预测价值。

方法

对105例经活检证实为HCV肝硬化的患者（69例男性，36例女性；年龄范围51 - 90岁，中位年龄66岁）进行前瞻性监测，观察HCC的发生情况，中位监测时间为64个月。通过微血管密度（MVD）评估血管生成，在肝活检时用MIB1和增殖细胞核抗原（PCNA）指数评估肝细胞更新情况。

结果

46例患者（43.8%）在中位时间55（6 - 120）个月后发生HCC，59例（56.2%）未发生。根据每个指标的中位数将患者分为两组。低微血管密度（中位MVD = 3；范围0 - 20）和高微血管密度（中位MVD = 7；范围1 - 24）患者之间的差异具有统计学意义（χ² = 22.06；P < 0.0001），而MIB1或PCNA则不然（MIB - 1：χ² = 1.41；P = 0.2351；PCNA：χ² = 1.27；P = 0.2589）。发生HCC的患者中位MVD高于未发生者。MVD≤4的患者无HCC间隔时间显著更长（P = 0.0006）。未发现MIB1或PCNA与MVD之间存在相关性（MIB - 1 r² = 0.00007116，P = 0.9281；PCNA：r² = 0.001950；P = 0.6692）。只有MVD能够预测这些患者中HCC的发生。在其他已知的HCC危险因素中，只有男性与风险增加具有统计学相关性。