Guo F Y, Yang J, Xiong S M, Zhu M Q, Gao S, Li J P
The Third Hospital Affiliated to Nantong University, Wu Xi 214000, China.
Zhonghua Gan Zang Bing Za Zhi. 2018 Sep 20;26(9):666-669. doi: 10.3760/cma.j.issn.1007-3418.2018.09.006.
To investigate epidermal growth factor receptor (EGFR) and thymidylate synthase (TS) expression in primary liver cancer, and analyze its clinicopathological features and prognostic significance. Immunohistochemistry was performed using EnVision method to detect EGFR and TS expression in 41 cases of liver cancer. Correlation coefficient between EGFR and TS was calculated by Spearman method. Fisher's exact probability method or (2) test was used to analyze the clinicopathological features of EGFR and TS. Kaplan-Meier method was used to calculate the survival rate of patients in conjunction with the log-rank test.COX proportional hazard regression model was used to analyze the prognostic factors of patients. ROC curve was used to analyze the predictive accuracy of EGFR and TS for prognosis. The positive rates of EGFR and TS in liver cancer tissues were 34.15% and 39.02%, respectively. There was a positive correlation between EGFR and TS expressions, and the difference was statistically significant ( < 0.05). EGFR was associated with tumor size and tissue differentiation ( < 0.05) in HCC patients, whereas TS was associated with tissue differentiation ( < 0.05). There was no significant difference in prognostic effect of EGFR on survival rate ( > 0.05). TS prognostic effect on survival rate was statistically significant ( < 0.05). HR of EGFR was 0.210 with 95% , 0.052-0.852, = 0.029; indicating that the risk of death in patients with negative EGFR was 0.210 times higher than that in patients with positive EGFR. HR of TS was 2.496, with 95% , 1.325-4.701, = 0.005, indicating that the risk of death increased by 2.496 times with the same level of EGFR. The area under the EGFR curve was 0.553 and its approximate reference confidence interval was 95% (0.355, 0.751), indicating that EGFR was a risk factor for death and the area under the TS curve was 0.695, and its approximate reference confidence interval was 95% (0.513, 0.878), indicating that TS was a risk factor for death. EGFR and TS were equally expressed in primary liver cancer, and EGFR and TS expressions were positively correlated. EGFR and TS had an effect on the degree of tissue differentiation in patients with liver cancer. EGFR and TS were risk factors for prognosis, and TS may assist EGFR.
探讨原发性肝癌中表皮生长因子受体（EGFR）和胸苷酸合成酶（TS）的表达情况，并分析其临床病理特征及预后意义。采用EnVision法进行免疫组织化学检测41例肝癌组织中EGFR和TS的表达。用Spearman法计算EGFR与TS的相关系数。采用Fisher确切概率法或卡方检验分析EGFR和TS的临床病理特征。用Kaplan-Meier法结合对数秩检验计算患者生存率。采用COX比例风险回归模型分析患者的预后因素。用ROC曲线分析EGFR和TS对预后的预测准确性。肝癌组织中EGFR和TS的阳性率分别为34.15%和39.02%。EGFR与TS表达呈正相关，差异有统计学意义（P<0.05）。在肝癌患者中，EGFR与肿瘤大小及组织分化相关（P<0.05），而TS与组织分化相关（P<0.05）。EGFR对生存率的预后影响无显著差异（P>0.05）。TS对生存率的预后影响有统计学意义（P<0.05）。EGFR的HR为0.210，95%CI为0.052 - 0.852，P = 0.029；表明EGFR阴性患者的死亡风险是EGFR阳性患者的0.210倍。TS的HR为2.496，95%CI为1.325 - 4.701，P = 0.005，表明在EGFR水平相同的情况下，死亡风险增加2.496倍。EGFR曲线下面积为0.553，其近似参考置信区间为95%（0.355，0.751），表明EGFR是死亡危险因素；TS曲线下面积为0.695，其近似参考置信区间为95%（0.513，0.878），表明TS是死亡危险因素。EGFR和TS在原发性肝癌中表达相当，且EGFR与TS表达呈正相关。EGFR和TS对肝癌患者的组织分化程度有影响。EGFR和TS是预后危险因素，且TS可能辅助EGFR。
