肝细胞癌患者微血管计数与肝切除术后生存率的关系。
Relationship between microvessel count and post-hepatectomy survival in patients with hepatocellular carcinoma.
作者信息
Nanashima Atsushi, Nakayama Toshiyuki, Sumida Yorihisa, Abo Takafumi, Takeshita Hiroaki, Shibata Kenichirou, Hidaka Shigekazu, Sawai Terumitsu, Yasutake Toru, Nagayasu Takeshi
机构信息
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan.
出版信息
World J Gastroenterol. 2008 Aug 21;14(31):4915-22. doi: 10.3748/wjg.14.4915.
AIM
To elucidate the relationship between the microvessel count (MVC) by CD34 analyzed by immunohistochemical method and prognosis in hepatocellular carcinoma (HCC) patients who underwent hepatectomy based on our preliminary study.
METHODS
We examined relationships between MVC and clinicopathological factors in 128 HCC patients. The modified Japan Integrated Staging score (mJIS) was applied to examine subsets of HCC patients.
RESULTS
Median MVC was 178/mm(2), which was used as a cut-off value. MVC was not significantly associated with any clinicopathologic factors or postoperative recurrent rate. Lower MVC was associated with poor disease-free and overall survivals by univariate analysis (P = 0.039 and P = 0.087, respectively) and lower MVC represented an independent poor prognostic factor in disease-free survival by Cox's multivariate analysis (risk ratio, 1.64; P = 0.024), in addition to tumor size, vascular invasion, macroscopic finding and hepatic dysfunction. Significant differences in disease-free and overall survivals by MVC were observed in HCC patients with mJIS 2 (P = 0.046 and P = 0.0014, respectively), but not in those with other scores.
CONCLUSION
Tumor MVC appears to offer a useful prognostic marker of HCC patient survival, particularly in HCC patients with mJIS 2.
目的
基于我们的初步研究，阐明采用免疫组织化学方法分析的CD34微血管计数（MVC）与接受肝切除术的肝细胞癌（HCC）患者预后之间的关系。
方法
我们检测了128例HCC患者中MVC与临床病理因素之间的关系。应用改良日本综合分期评分（mJIS）来分析HCC患者亚组。
结果
MVC中位数为178/mm(2)，将其用作临界值。MVC与任何临床病理因素或术后复发率均无显著相关性。单因素分析显示，较低的MVC与无病生存期和总生存期较差相关（分别为P = 0.039和P = 0.087），并且除肿瘤大小、血管侵犯、大体表现和肝功能障碍外，Cox多因素分析显示较低的MVC是无病生存期独立的不良预后因素（风险比，1.64；P = 0.024）。在mJIS 2的HCC患者中观察到MVC在无病生存期和总生存期方面存在显著差异（分别为P = 0.046和P = 0.0014），但在其他评分的患者中未观察到。
结论
肿瘤MVC似乎是HCC患者生存的一个有用的预后标志物，尤其是在mJIS 2的HCC患者中。
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