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目的:探讨肝细胞癌(HCC)组织中Smac(第二个线粒体Caspase激活因子)的表达及其与细胞凋亡和增殖的关系。方法:应用免疫组化二步法检测HCC及相应癌旁肝硬化组织各41例、肝血管瘤旁正常对照组织9例中Smac、增殖细胞核抗原(PCNA)的表达;应用TUNEL法检测组织中细胞的凋亡。结果:在41例HCC组织中,Smac阳性数为14例(34.14%),相应癌旁肝硬化组织为23例(56.10%),肝血管瘤旁正常对照组织为7例(77.78%),HCC组织中Smac的阳性率与相应癌旁及正常组织相比差异有统计学意义,χ2值分别为3.989和4.115,P值分别为0.046和0.042;HCC组织中Smac蛋白的表达与细胞的凋亡增殖比有相关性,t′=2.26,P<0.05,而与患者的年龄、组织分化程度等临床病理指标均无相关性,P均>0.05。结论:Smac的相对低表达或表达缺失在一定程度上打破了HCC组织中细胞凋亡与增殖之间的动态平衡,在HCC的形成过程中起到了重要的作用。
Objective: To investigate the expression of Smac (second mitochondrial Caspase-activating factor) in hepatocellular carcinoma (HCC) and its relationship with apoptosis and proliferation. Methods: Immunohistochemistry was used to detect the expression of Smac and proliferating cell nuclear antigen (PCNA) in 41 cases of HCC, corresponding adjacent noncancerous cirrhosis tissues and 9 cases of adjacent normal liver tissues. Immunohistochemistry was used to detect the expression of Smac and proliferating cell nuclear antigen (PCNA) Apoptosis. RESULTS: The positive number of Smac was 14 (34.14%) in 41 HCC tissues, 23 (56.10%) in the corresponding paracancerous cirrhosis tissues, 7 (77.78%) in the normal control tissues adjacent to the hepatic hemangiomas, The positive rate of Smac in the tissue was significantly different from that in adjacent normal tissues (χ2 = 3.989 and 4.115, P = 0.046 and 0.042, respectively). The expression of Smac protein in HCC tissues was significantly higher than that in normal tissues T = 2.26, P <0.05, but not related with clinicopathological parameters such as patient’s age, histological differentiation, P> 0.05. CONCLUSIONS: The relatively low expression or absence of Smac breaks down the dynamic balance between apoptosis and proliferation in HCC tissue and plays an important role in the formation of HCC.