Division of Radiation Cancer Research, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.
Ann Surg Oncol. 2012 Jul;19 Suppl 3:S328-38. doi: 10.1245/s10434-011-1709-0. Epub 2011 Apr 30.
The tissue environment in the region of hepatocellular carcinoma (HCC) influences both vascular invasion and recurrence. Thus, HCC patient prognosis depends on the characteristics not only of the tumor but also those of adjacent surrounding liver tissue.
Expression profiles of both tumor and adjacent liver tissue following curative resection were measured to discriminate 56 hepatitis B virus-positive HCC patients into subgroups based on survival risk. This approach was further tested in 40 patients.
Expression profiles of both tumor and adjacent liver tissue successfully discriminated 56 training samples into 2 subgroups, those at low- or high-risk for survival and recurrence. However, the prognostic gene set selected for tumor tissue was quite different from that for adjacent tissues. This variation in prognostic genes resulted in a change in allocation of patients within each low- or high-risk group. Combination of survival subgroups from tumor and adjacent liver tissue significantly improved the prediction of prognostic outcome. This integrative approach was confirmed to be effective in a further 40 test patients. A clinicopathological study showed that survival subgroups divided by tumor and adjacent liver tissue gene expression were also statistically associated with UICC stage and extent of cell differentiation, respectively.
Variation in gene expression during the nontumor stage as well as the tumor stage may affect the prognosis of HCC patients, and integration of the gene expression profiles of HCC and adjacent liver tissue increases discriminatory effectiveness between patient groups, predicting clinical outcomes with enhanced statistical reliability.
肝癌（HCC）区域的组织环境影响血管侵犯和复发。因此，HCC 患者的预后不仅取决于肿瘤的特征，还取决于相邻肝组织的特征。
通过测量根治性切除术后肿瘤和相邻肝组织的表达谱，根据生存风险将 56 例乙型肝炎病毒阳性 HCC 患者分为亚组。在 40 例患者中进一步进行了该方法的测试。
肿瘤和相邻肝组织的表达谱成功地将 56 个训练样本分为低风险或高风险的生存和复发亚组。然而，用于肿瘤组织的预后基因集与用于相邻组织的基因集非常不同。这种预后基因的变化导致每个低风险或高风险组内的患者分配发生变化。肿瘤和相邻肝组织的生存亚组的组合显著提高了预后结果的预测能力。这种综合方法在另外 40 例测试患者中得到了验证。临床病理研究表明，由肿瘤和相邻肝组织基因表达划分的生存亚组与 UICC 分期和细胞分化程度也分别具有统计学相关性。
非肿瘤阶段和肿瘤阶段的基因表达变化可能影响 HCC 患者的预后，并且 HCC 和相邻肝组织的基因表达谱的整合增加了患者组之间的区分效果，以增强统计可靠性的方式预测临床结局。
