The Prognostic Role of Mitotic Index in Hepatocellular Carcinoma Patients after Curative Hepatectomy
The Prognostic Role of Mitotic Index in Hepatocellular Carcinoma Patients after Curative Hepatectomy
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DOI：
10.4143/crt.2014.321
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发表时间：
2016-01-01
影响因子：
4.6
通讯作者：
Park, Cheol-Keun
中科院分区：
文献类型：
--
作者：
Ha, Sang Yun;Choi, Misun;Park, Cheol-Keun
目的高增殖率是恶性肿瘤的标志。有丝分裂指数是一种简单实用的细胞增殖分析方法。然而，有丝分裂指数作为肝细胞癌（HCC）患者预后的预测因子的实用性尚未确定。因此，我们研究有丝分裂指数作为HCC patients.Materials和MethodsWe的预后标志物计数有丝分裂细胞的数量在10个高功率领域的肿瘤面积苏木精和伊红染色的幻灯片代表282手术切除的HCC。有丝分裂细胞的最高数目被定义为mitotic index.ResultsHigh有丝分裂指数观察282 HCC中的127。有丝分裂指数高与年龄小、肿瘤大、Edmondson分级高、微血管侵犯、门静脉侵犯、肝内转移、美国癌症联合委员会（AJCC）T分期高、巴塞罗那临床肝癌（BCLC）分期高、甲胎蛋白水平高、B型肝炎病毒病因和肝硬化显著相关。有丝分裂指数高的患者的疾病特异性生存期（DSS）较短（p < 0.001），无复发生存期往往较短（p=0.112）。在肿瘤体积较大、微血管浸润、肝内转移、AJCC T分期较高和BLCL分期较高的患者中，高有丝分裂指数对DSS有不利影响（分别为p=0.001、p=0.008、p=0.003、p=0.012和p < 0.001）。此外，高有丝分裂指数是一个独立的预测较短的DSS（p=0.004）。结论高有丝分裂指数可能是一种新的预测DSS在肝癌患者，并可能有效用作为一个辅助预后因素在肝癌。
PurposeHigh proliferation rate is a hallmark of cancer. The mitotic index is a useful and simple method for analysis of cell proliferation. However, the practical utility of mitotic index as a predictor of prognosis in patients with hepatocellular carcinoma (HCC) has not been determined. Therefore, we examined mitotic index as a prognostic marker in HCC patients.Materials and MethodsWe counted the number of mitotic cells in 10 high-power fields of the tumor area on hematoxylin and eosin-stained slides representing 282 surgically resected HCCs. The highest number of mitotic cells was defined as the mitotic index.ResultsHigh mitotic index was observed in 127 of 282 HCCs. High mitotic index showed significant association with younger age, larger tumor size, higher Edmondson grade, microvascular invasion, major portal vein invasion, intrahepatic metastasis, higher American Joint Committee on Cancer (AJCC) T-stage, higher Barcelona Clinic Liver Cancer (BCLC) stage, higher alpha-fetoprotein level, hepatitis B virus etiology, and liver cirrhosis. Patients with high mitotic index had shorter disease-specific survival (DSS) (p < 0.001) and tended to have shorter recurrence-free survival (p=0.112). In subgroup analysis among patients with a larger tumor size, microvascular invasion, intrahepatic metastasis, higher AJCC T-stage, and higher BLCL stage, high mitotic index showed unfavorable influences on DSS (p=0.001, p=0.008, p=0.003, p=0.012, and p < 0.001, respectively). In addition, high mitotic index was an independent predictor of shorter DSS (p=0.004).ConclusionHigh mitotic index may be a novel predictor of DSS in patients with HCC and may have utility as an auxiliary prognostic factor in HCC.