Lee Boin, Ha Sang Yun, Song Dae Hyun, Lee Hyun Woo, Cho Soo Youn, Park Cheol-Keun
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Gut Liver. 2014 Nov;8(6):662-8. doi: 10.5009/gnl13392. Epub 2014 Nov 15.
BACKGROUND/AIMS: Ribonucleotide reductase subunit M2 (RRM2) catalyzes the production of deoxynucleotide triphosphates, which are necessary for DNA synthesis. RRM2 has been reported to play an active role in tumor progression, and elevated RRM2 levels have been correlated with poor prognosis for colorectal cancer patients. This study aimed to elucidate the prognostic significance of RRM2 protein expression in hepatocellular carcinoma after surgery.
RRM2 protein expression was evaluated using immunohistochemistry in tumor tissues from 259 hepatocellular carcinoma patients who underwent curative hepatectomy.
High RRM2 expression was observed in 210 of 259 patients (81.1%) with hepatocellular carcinomas. High RRM2 expression was significantly associated with viral etiology (p=0.035) and liver cirrhosis (p=0.036). High RRM2 expression was correlated with early recurrence (p=0.004) but not with late recurrence (p=0.144). Logistic regression analysis revealed that high RRM2 expression (p=0.040) and intrahepatic metastasis (p<0.001) were independent predictors of early recurrence. High RRM2 expression unfavorably influenced both shorter recurrence-free survival (p=0.011) and shorter disease-specific survival (p=0.002) and was an independent predictor of shorter disease-specific survival (p=0.008).
High RRM2 protein expression might be a useful marker for predicting early recurrence and may be a marker for poor prognosis of hepatocellular carcinoma after curative hepatectomy.
背景/目的:核糖核苷酸还原酶亚基M2(RRM2)催化脱氧核苷三磷酸的生成,而脱氧核苷三磷酸是DNA合成所必需的。据报道,RRM2在肿瘤进展中发挥积极作用,RRM2水平升高与结直肠癌患者的不良预后相关。本研究旨在阐明RRM2蛋白表达在肝细胞癌术后的预后意义。
采用免疫组织化学法评估259例行根治性肝切除术的肝细胞癌患者肿瘤组织中RRM2蛋白的表达。
259例肝细胞癌患者中,210例(81.1%)观察到RRM2高表达。RRM2高表达与病毒病因(p=0.035)和肝硬化(p=0.036)显著相关。RRM2高表达与早期复发相关(p=0.004),但与晚期复发无关(p=0.144)。Logistic回归分析显示,RRM2高表达(p=0.040)和肝内转移(p<0.001)是早期复发的独立预测因素。RRM2高表达对无复发生存期缩短(p=0.011)和疾病特异性生存期缩短(p=0.002)均有不利影响,并且是疾病特异性生存期缩短的独立预测因素(p=0.008)。
RRM2蛋白高表达可能是预测早期复发的有用标志物,也可能是根治性肝切除术后肝细胞癌预后不良的标志物。