摘要
目的探讨肝内胆管结石相关肝内胆管癌(HICC)组织中肝癌衍生生长因子(HDGF)、血管内皮生长因子(VEGF)和黏蛋白5B(MUC5B)的表达及其临床意义。方法回顾性分析1999年10月至2019年10月期间温州医科大学附属第三医院收治的行肝切除术的79例肝内胆管结石或HICC患者的临床资料。79例患者中HICC者41例(HICC组),肝内胆管结石者38例(肝内胆管结石组)。另选取同期行肝切除术的37例肝良性肿瘤患者为对照组。共入选行肝切除术的患者116例,其中男性47例,女性69例,年龄(66.1±3.2)岁。对比三组患者HDGF、VEGF和MUC5B的阳性表达情况。在41例HICC患者中,考察HDGF、VEGF与MUC5B阳性表达与其临床特征的相关性。结果与对照组相比,肝内胆管结石组和HICC组患者HDGF、VEGF和MUC5B阳性表达率增加,差异均具有统计学意义(P<0.05)。与肝内胆管结石组相比,HICC组患者HDGF、VEGF和MUC5B阳性表达率增加,差异有统计学意义(P<0.05)。HICC患者VEGF阳性表达与肿瘤分化程度、肿瘤局部浸润程度、肿瘤长径、肿瘤分期、肿瘤糖类抗原(CA)19-9水平及淋巴结转移相关(P<0.05);MUC5B阳性表达与肿瘤分化程度、肿瘤局部浸润程度、肿瘤长径、肿瘤分期、CA19-9水平及淋巴结转移相关(P<0.05)。Spearman相关分析结果显示,HDGF与VEGF在HICC组织内呈正相关表达(r=0.935,P<0.01)。生存分析结果表明,VEGF阳性表达HICC患者术后1、3、5年的累积生存率(36.7%、17.1%、7.3%)较阴性表达患者同期累积生存率(51.2%、26.8%、19.5%)低,差异有统计学意义(P<0.01);MUC5B阳性表达HICC患者术后1、3、5年的累积生存率(34.1%、17.1%、4.9%)较阴性表达患者同期累积生存率(53.7%、31.7%、17.1%)低,差异有统计学意义(P<0.01)。结论HDGF可作为早期评估HICC发病的参考指标,而VEGF与MUC5B的过表达可作为评判HICC进展及预后的重要指标。
Objective To study the roles of hepatoma-derived growth factor(HDGF),vascular endothelial growth factor(VEGF)and mucin 5B(MUC5B)in hepatolithiasis associated with intrahepatic cholangiocarcinoma(HICC).Methods The clinical data and tissue specimens of 116 patients who underwent hepatectomy at the Third Affiliated Hospital of Wenzhou Medical University from October 1999 to October 2019 were retrospectively analyzed.There were 41 patients with HICC(the HICC group),38 patients with intrahepatic cholangiolithiasis(the intrahepatic cholangiolithiasis group),and 37 patients with benign liver tumor who underwent hepatectomy(the control group).There were 47 males and 69 females,with age of(66.1±3.2)years old.The positive expressions of HDGF,VEGF and MUC5B in the three groups were compared.In 41 patients with HICC,the correlation between positive expressions of HDGF,VEGF and MUC5B with patients’clinical characteristics were studied.Results Compared with the control group,the positive expression rates of HDGF,VEGF and MUC5B in the HICC group and the intrahepatic cholangiolithiasis group were significantly increased,(P<0.05).Compared with the intrahepatic cholangiolithiasis group,the positive expression rates of HDGF,VEGF and MUC5B in the HICC group were significantly increased(P<0.05).Positive expression of VEGF in HICC patients was correlated with tumor differentiation,tumor local invasion,tumor length,tumor stage,tumor carbohydrate antigen CA19-9 level and lymph node metastasis(P<0.05).Spearman correlation analysis showed that HDGF was positively correlated with VEGF expression in HICC tissues specimens(r=0.935,P<0.01).Survival analysis showed that the cumulative survival rates(36.7%,17.1%,7.3%)of patients with positive expression of VEGF were significantly lower than that of patients with negative expression(51.2%,26.8%,19.5%)at 1,3,5 years after surgery(P<0.01).The cumulative survival rate(34.1%,17.1%,4.9%)of patients with MUC5B positive expression were significantly lower than that of patients with negative expressi
作者
李金海
朱明辉
孙丽形
蒲青凡
张海峰
潘升华
Li Jinhai;Zhu Minghui;Sun Lixing;Pu Qingfan;Zhang Haifeng;Pan Shenghua(Department of Hepatobiliary Surgery,the Third Affiliated Hospital of Wenzhou Medical University,Wenzhou 325200,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2022年第2期97-102,共6页
Chinese Journal of Hepatobiliary Surgery
基金
温州市科技局计划项目(Y20210917)。
关键词
胆管肿瘤
胆结石
血管内皮生长因子
肝癌衍生生长因子
黏蛋白5B
Bile duct neoplasms
Cholelithiasis
Vascular endothelial growth factors
Hepatoma-derived growth factor
Mucin 5B
