抗丙型肝炎病毒阳性肝硬化患者肝细胞增殖在肝细胞癌发生中的意义。

Significance of hepatocellular proliferation in the development of hepatocellular carcinoma from anti-hepatitis C virus-positive cirrhotic patients.

作者信息

Tarao K, Ohkawa S, Shimizu A, Harada M, Nakamura Y, Ito Y, Tamai S, Hoshino H, Inoue T, Kanisawa M

机构信息

Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan.

出版信息

Cancer. 1994 Feb 15;73(4):1149-54. doi: 10.1002/1097-0142(19940215)73:4<1149::aid-cncr2820730405>3.0.co;2-9.

DOI:10.1002/1097-0142(19940215)73:4<1149::aid-cncr2820730405>3.0.co;2-9

PMID:7508816

Abstract

BACKGROUND

There is a hypothesis explaining the pathogenesis of carcinoma that increased proliferation of tissue cells correlates with the development of carcinoma, presumably by increased rate of random mutations and by promotion. In this study, the significance of hepatocellular proliferation in the development of human hepatocellular carcinoma (HCC) from anti-hepatitis C virus (HCV)-positive cirrhotic patients was studied.

METHODS

Twenty-eight Child A cirrhotic patients who were anti-HCV (C-100 antibody) positive were studied. At the beginning of the study, the in vitro uptake of bromodeoxyuridine (BrdU, a thymidine analogue) by hepatocytes in biopsied liver specimens was investigated as labeling indices (LIs), and they were divided into high-DNA synthetic (BrdU LI > or = 1.5%) and low-DNA synthetic (BrdU LI < 1.5%) groups. The patients were then surveyed prospectively with frequent ultrasonography (every 3 months) for the development of HCC for 3 years.

RESULTS

The mean BrdU LI plus or minus standard deviation for 14 cirrhotic patients with high-DNA synthesis activity (BrdU LI > or = 1.5%) was 2.7 +/- 0.8%, and this was significantly (P < 0.001) higher than that for 14 cirrhotic patients with low-DNA synthesis activity (BrdU LI < 1.5%, 0.5 +/- 0.3%). Nine of 14 (64.3%) of the cirrhotic patients with high-DNA synthesis activity developed HCC in the 3-year period, in contrast to only 2 of 14 (14.3%) of the cirrhotic patients with low-DNA synthesis activity P < 0.05).

摘要

背景

有一种解释癌症发病机制的假说，即组织细胞增殖增加与癌症的发生相关，推测是通过随机突变率的增加和促进作用。在本研究中，研究了抗丙型肝炎病毒（HCV）阳性肝硬化患者中肝细胞增殖在人类肝细胞癌（HCC）发生中的意义。

方法

研究了28例抗HCV（C-100抗体）阳性的Child A级肝硬化患者。在研究开始时，将活检肝标本中肝细胞对溴脱氧尿苷（BrdU，一种胸腺嘧啶类似物）的体外摄取作为标记指数（LIs）进行研究，并将他们分为高DNA合成（BrdU LI≥1.5%）和低DNA合成（BrdU LI＜1.5%）组。然后对患者进行前瞻性随访，每3个月进行一次超声检查，持续3年以观察HCC的发生情况。

结果

14例具有高DNA合成活性（BrdU LI≥1.5%）的肝硬化患者的平均BrdU LI±标准差为2.7±0.8%，这显著高于（P＜0.001）14例具有低DNA合成活性（BrdU LI＜1.5%，0.5±0.3%）的肝硬化患者。14例具有高DNA合成活性的肝硬化患者中有9例（64.3%）在3年期间发生了HCC，相比之下，14例具有低DNA合成活性的肝硬化患者中只有2例（14.3%）发生了HCC（P＜0.05）。