Lin Y X, Chen K, An F M, Wang Y F, Wu X B, Zhan Q, Zhang G Q
Department of Gastroenterology, Wuxi People's Hospital affiliated to NanJing Medical University, Wuxi 214000, China.
Zhonghua Gan Zang Bing Za Zhi. 2021 Oct 20;29(10):1006-1013. doi: 10.3760/cma.j.cn501113-20200416-00189.
Hepatocellular carcinoma (HCC) is the fourth most dominant cancer in the world and the second leading cause of cancer-related deaths in the China. With the increase in the incidence of metabolic syndrome (MS) in the population, the correlation between MS and HCC has gradually been recognized. MS manifests as non-alcoholic fatty liver disease (shortly known as NAFLD) in the liver. A large number of research results has shown that the development of fatty liver is closely related to the occurrence of HCC, in which lipid metabolism plays a key regulatory role, and lipid metabolism is regulated by fatty acid binding protein (FABP). This study signifies the lipid metabolism analysis and the key FABP expression conditions in HCC. Data of patients who were first diagnosed with primary HCC between January 2016 to July 2019 were collected, and were divided into two groups according to the etiology, namely the viral and non-viral hepatitis-related HCC group. The relationship between MS-related factors and HCC was analyzed by t-test and chi square test. The expressions of FABP1, FABP4 and FABP5 were detected in cancer and adjacent tissues by immunohistochemistry, and the expressions of FABP1, FABP4 and FABP5 in HCC with fatty liver were detected by immunofluorescence. Finally, the expressional characteristics of the above-mentioned FABPs in HCC patients were analyzed with different clinicopathological features. There were statistically significant differences in the rate of abnormal lipid metabolism and the number of abnormalities in MS-related factors between the viral and non-viral hepatitis-related HCC group. FABP1, FABP4, and FABP5 expression in HCC tissues were lower than the corresponding adjacent tumor tissues. Compared with simple HCC, FABP1, FABP4, FABP5 expression were increased in HCC tissues with steatosis, and the expression of FABP was closely related to the clinical characteristics of patients. Abnormal lipid metabolism is closely related to non-viral hepatitis-related HCC. The expression of lipid metabolism regulatory proteins FABP1, FABP4, and FABP5 are down-regulated in HCC tissues, but up-regulated in HCC with fatty liver, suggesting that the relationship between MS, especially dyslipidemia, and HCC should be paid attention to in clinical practice for early intervention. FABP1, FABP4, FABP5 may regulate HCC occurrence and development.
肝细胞癌(HCC)是全球第四大常见癌症,在中国是癌症相关死亡的第二大主要原因。随着人群中代谢综合征(MS)发病率的上升,MS与HCC之间的相关性逐渐得到认可。MS在肝脏中表现为非酒精性脂肪性肝病(简称为NAFLD)。大量研究结果表明,脂肪肝的发展与HCC的发生密切相关,其中脂质代谢起着关键的调节作用,而脂质代谢受脂肪酸结合蛋白(FABP)调控。本研究旨在分析HCC中的脂质代谢情况以及关键FABP的表达状况。收集了2016年1月至2019年7月首次诊断为原发性HCC的患者数据,并根据病因将其分为两组,即病毒性和非病毒性肝炎相关HCC组。通过t检验和卡方检验分析MS相关因素与HCC之间的关系。采用免疫组织化学法检测癌组织和癌旁组织中FABP1、FABP4和FABP5的表达,采用免疫荧光法检测脂肪肝HCC中FABP1、FABP4和FABP5的表达。最后,分析上述FABP在HCC患者中的表达特征与不同临床病理特征之间的关系。病毒性和非病毒性肝炎相关HCC组在脂质代谢异常率和MS相关因素异常数量方面存在统计学显著差异。HCC组织中FABP1、FABP4和FABP5的表达低于相应的癌旁组织。与单纯HCC相比,脂肪肝HCC组织中FABP1、FABP4、FABP5的表达升高,且FABP的表达与患者的临床特征密切相关。脂质代谢异常与非病毒性肝炎相关HCC密切相关。脂质代谢调节蛋白FABP1、FABP4和FABP5在HCC组织中表达下调,但在脂肪肝HCC中表达上调,提示在临床实践中应关注MS,尤其是血脂异常与HCC之间的关系,以便进行早期干预。FABP1、FABP4、FABP5可能调节HCC的发生发展。