目的 探討T-鈣黏蛋白在肝癌肝移植患者癌組織和癌旁組織中的表達及其與腫瘤復(fù)發(fā)轉(zhuǎn)移的關(guān)系。方法 收集解放軍聯(lián)勤保障部隊第九〇〇醫(yī)院2003年1月-2012年12月行原位肝移植手術(shù)的183例肝細胞癌（HCC）患者的臨床資料，以符合肝癌肝移植米蘭標準，且被切除肝臟的癌旁組織無微小血管侵犯（MVI）的76例患者為研究對象。根據(jù)術(shù)后隨訪中腫瘤是否復(fù)發(fā)轉(zhuǎn)移分為復(fù)發(fā)轉(zhuǎn)移組和無復(fù)發(fā)轉(zhuǎn)移組，采用免疫組化法檢測T-鈣黏蛋白基因，觀察其在兩組患者癌組織和癌旁組織中的表達，比較術(shù)后5年內(nèi)出現(xiàn)復(fù)發(fā)轉(zhuǎn)移患者與未出現(xiàn)復(fù)發(fā)轉(zhuǎn)移患者癌組織中T-鈣黏蛋白基因的表達差異。結(jié)果 納入的76例患者5年總復(fù)發(fā)轉(zhuǎn)移率為21.05%，其中無MVI的患者46例（60.52%），術(shù)后肝癌復(fù)發(fā)轉(zhuǎn)移率為17.39%；肝癌組織中細胞膜T-鈣黏蛋白陽性表達率降低，缺失和異常表達明顯升高，占47.83%，而癌旁組織缺失及異常表達較少見，僅占6.52%；兩組相比差異具有統(tǒng)計學(xué)意義（χ²=19.828，P=0.000）；在出現(xiàn)復(fù)發(fā)轉(zhuǎn)移的肝癌肝移植患者中癌組織T-鈣黏蛋白異常表達（100%）與未復(fù)發(fā)轉(zhuǎn)移的肝癌肝移植患者的（36.84%）相比差異有顯著的統(tǒng)計學(xué)意義（χ²=10.565，P=0.001）。結(jié)論 T-鈣黏蛋白基因在HCC中缺失和異常表達率較高，且與肝移植術(shù)后肝細胞癌的復(fù)發(fā)轉(zhuǎn)移密切相關(guān)，有可能作為判斷HCC肝移植預(yù)后的預(yù)測指標和藥物干預(yù)的靶點。

Objection To investigate the difference of T-cadherin expression level between cancer and corresponding non-cancerous tissues in hepatocellular carcinoma (HCC) patients undergoing liver transplantation and the relationship between T-cadherin and tumor recurrence and metastasis. Methods A total of 183 patients who received liver transplantation for HCC at 900th Hospital of PLA from January 2003 to December 2012 were enrolled in this study, and 76 patients who met Milan Criteria For Liver Transplantation and had no microvascular invasion (MVI) in the para-carcinoma tissues were included. The patients were divided into two groups:recurrence & metastasis group and no recurrence & metastasis group, based on five years of follow-up after operation. The expression differences of T-cadherin between cancer and corresponding non-cancerous tissues of the two groups were observed, and within five years later after surgery, the expression differences of T-cadherin gene were compared with recurrence & metastasis and those without recurrence & metastasis in the cancer tissues of patients. Results The five-year cumulative recurrence and metastasis rate was 21.05% in 76 patients who met the Milan Criteria for liver transplantation of HCC, among which no MVI were 46 patients (60.52%), and the recurrence and metastasis rate was 17.39%. The rate of T-cadherin gene expression was low in cancer tissues, but its abnormal expression and deletion rate was up to 47.83%, which was significantly higher than that (6.52%) in the para-carcinoma tissues. The difference between the two groups was statistically significant (χ²=19.828, P=0.000). The T-cadherin abnormal expression rate of the recurrence & metastasis group (100%) was significantly different from that in the no recurrence & metastasis group (36.84%) (χ²=10.565, P=0.001) in cancer tissues. Conclusions The abnormal expression and deletion of Tcadherin gene in cancer tissues is closely related to the recurrence and metastasis of HCC after liver transplantation, and T-cadherin gene may be used as a prognostic indicator and drug research target for HCC patients undergoing liver transplantation.

R969.3

福建省自然科學(xué)基金（2016J01590），福建省社會發(fā)展引導(dǎo)性重點項目（2016Y0068），福建省科技創(chuàng)新聯(lián)合基金（2016Y9063）