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目的 :探讨A20基因[又称肿瘤坏死因子α诱导蛋白3(tumor necrosis factor alpha-induced protein 3,TNFAIP 3)基因]在肝细胞癌组织中的表达及其与预后的关系。方法 :选取86例原发性肝癌患者的手术切除标本(包括癌及癌旁组织)及26例肝血管瘤患者的正常肝组织标本,采用实时荧光定量PCR法检测A20在肝癌组织及其配对的癌旁组织和正常肝组织中的m RNA表达水平,并分析A20 m RNA表达水平与肝癌患者临床病理特征及接受根治性切除术后预后的关系。结果 :肝癌组织中A20 m RNA的相对表达水平显著高于血管瘤正常肝组织(1.620±0.155 vs 0.410±0.043,P<0.001);对应癌旁组织中A20 m RNA的表达水平(1.215±0.134)也显著高于血管瘤正常肝组织(P=0.001),但与肝癌组织相比的差异无统计学意义(P=0.087)。肝癌组织中A20的表达水平与患者肿瘤分化程度明显相关(P<0.001)。肝癌组织中A20高表达的患者术后总生存(overall survival,OS)率显著低于A20低表达组(P=0.016),至复发时间(time to recurrence,TTR)显著短于A20低表达组(P=0.011)。单因素分析表明,A20表达水平与肝癌患者的预后密切相关(OS:P=0.012;TTR:P=0.013);多因素分析表明,A20表达是影响肝癌患者生存与复发的独立预后因素(OS:P=0.021;TTR:P=0.018)。结论 :肝癌组织中A20 m RNA的表达水平显著高于正常肝组织。A20表达可能成为肝癌患者生存与复发的独立预后因素。
Objective: To investigate the expression of A20 gene (also known as tumor necrosis factor alpha-induced protein 3 (TNFAIP 3) gene in hepatocellular carcinoma and its relationship with prognosis. Methods: Totally 86 specimens of primary hepatocellular carcinoma (HCC) and 26 normal hepatic hemangioma specimens were collected from patients with HCC. Real-time fluorescent quantitative PCR was used to detect the expression of A20 in HCC tissue and its matched Paraneoplastic tissue and normal liver tissue m RNA expression levels and analysis of A20 m RNA expression in patients with hepatocellular carcinoma clinicopathological features and prognosis after radical resection. Results: The relative expression level of A20 mRNA in hepatocellular carcinoma tissues was significantly higher than that in normal liver tissues (1.620 ± 0.155 vs 0.410 ± 0.043, P <0.001). The expression level of A20 mRNA in paracancerous tissues (1.215 ± 0.134) But also significantly higher than that of normal hemangiomas (P = 0.001), but there was no significant difference compared with that of HCC (P = 0.087). The expression of A20 in hepatocellular carcinoma was significantly correlated with the degree of tumor differentiation (P <0.001). The overall survival rate of patients with A20 overexpression in hepatocellular carcinoma was significantly lower than that in A20 low expression group (P = 0.016), time to recurrence (TTR) was significantly shorter than that in A20 low expression group P = 0.011). Univariate analysis showed that the expression of A20 was closely related to the prognosis of patients with liver cancer (OS: P = 0.012; TTR: P = 0.013). Multivariate analysis showed that A20 expression was an independent prognostic factor of survival and recurrence in patients with liver cancer (OS: P = 0.021; TTR: P = 0.018). Conclusion: The expression of A20 mRNA in HCC tissues is significantly higher than that in normal liver tissues. A20 expression may become an independent prognostic factor for survival and recurrence in patients with liver cancer.