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目的探讨CD147作为肿瘤分子标志物预测肝移植术后肝癌复发的价值。方法为82例肝癌患者施行原位肝移植,切取病肝组织,采用免疫组化染色方法检测肝组织中CD147、血管内皮细胞生长因子(VEGF)的表达及微血管密度(MVD),并对受者进行随访,观察术后肝癌复发情况。结果82例术后随访1.5～41.6个月,38例于随访期间出现肝癌复发及转移,2例死于非肿瘤因素。CD147主要表达在肿瘤细胞的胞质及胞膜上,阳性细胞多呈弥漫性分布,在癌旁组织中呈低表达或不表达,在癌旁间质细胞上呈阴性表达。VEGF主要表达在肿瘤细胞的胞质中。CD34阳性表达高密度区多位于肿瘤边缘,在癌旁组织中呈阴性或稀疏分布,MVD为(215.22±132.54)/0.74mm~2。CD147与MVD(P<0.01)及VEGF表达(P<0.01)呈显著正相关。CD147的阳性表达与pTNM肿瘤分期(P<0.01)、肿瘤大小(P<0.01)及门静脉癌栓(P<0.01)呈显著正相关,也与术前血清甲胎蛋白呈显著正相关(P<0.01)。经单因素及多因素分析,CD147强阳性表达可作为预测术后肝癌复发的独立预见因子。结论CD147可作为预测因子预警肝移植术后肝癌复发,有助于筛选合适的肝移植候选者。
Objective To investigate the value of CD147 as a tumor molecular marker in predicting the recurrence of liver cancer after liver transplantation. METHODS: Totally 82 hepatocellular carcinoma patients underwent orthotopic liver transplantation. The diseased liver tissue was harvested and the expression of CD147 and vascular endothelial growth factor (VEGF) and microvessel density (MVD) in liver tissues were detected by immunohistochemical staining. Follow-up, observation of recurrence of liver cancer. Results 82 cases were followed up for 1.5 to 41.6 months. 38 cases showed recurrence and metastasis of liver cancer and 2 died of non-tumor factors during follow-up. CD147 is mainly expressed in the cytoplasm and membrane of tumor cells. Most of the positive cells are diffusely distributed, with low or no expression in the paracancerous tissues and negatively expressed in the para-cancerous stromal cells. VEGF is mainly expressed in the cytoplasm of tumor cells. CD34 positive expression of high-density area mostly located in the edge of the tumor in the paracancerous tissue was negative or sparse distribution, MVD was (215.22 ± 132.54) /0.74mm ~ 2. CD147 was positively correlated with MVD (P <0.01) and VEGF expression (P <0.01). The positive expression of CD147 was positively correlated with tumor size (P <0.01), tumor size (P <0.01) and portal vein tumor thrombus (P <0.01), but also positively correlated with preoperative serum alpha-fetoprotein (P < 0.01). Univariate and multivariate analysis showed that the strong positive expression of CD147 could be used as an independent predictive factor for the recurrence of postoperative liver cancer. Conclusion CD147 can be used as a predictor of liver cancer recurrence after liver transplantation, which is helpful to screen suitable candidates for liver transplantation.