Expression of biliary antigen and its clinical significance in hepatocellular carcinoma
Expression of biliary antigen and its clinical significance in hepatocellular carcinoma
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DOI：
10.3349/ymj.1999.40.5.472
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发表时间：
1999-10-01
影响因子：
2.4
通讯作者：
Kim, BR
中科院分区：
文献类型：
--
作者：
Yoon, DS;Jeong, J;Kim, BR
为了对具有不同临床病理特征的肝细胞癌进行分类，我们在假设肝细胞和胆管上皮细胞起源于同一前体细胞的基础上，根据胆汁抗原的表达将肝细胞癌分为两组，并对两组的临床和病理特征进行了研究。从1991~1995年的202例肝细胞癌病例中筛选出40例未经手术治疗且有至少2年随访资料的病例。用免疫组织化学方法检测胆汁抗原(AE1、细胞角蛋白19)、P53、AFP和Ki-67在肿瘤组织中的表达。细胞角蛋白19阳性1例(2.5%)，AE1阳性40%，P53过度表达20%，AFP阳性45%。胆汁抗原阳性组(16例)和阴性组(24例)在平均年龄、性别、术前血清AFP水平、Child分级和肿瘤大小方面均无统计学差异。胆汁抗原阴性组HBs Ag阳性率为66.7%，胆汁抗原阳性组为93.8%，差异有统计学意义(p=0.048)。胆汁抗原(-)组Edmonson-Steiner I/II级和III/IV级分别为15例和9例，胆汁抗原(+)组分别为4例和12例，差异有统计学意义(p=0.024)。胆汁抗原(-)组1、3、5年无瘤生存率分别为69.7%、40.9%和40.9%，胆汁抗原(+)组分别为73.7%、39.1%和39.1%，差异无统计学意义。胆汁抗原阴性组1、3、5年总生存率分别为91.7%、73.8%、66.4%，阳性组为68.8%、34.4%、34.4%，胆汁抗原阴性组总生存率明显高于阴性组(p=0.045)。胆汁抗原阳性组组织学分化差，乙肝表面抗原阳性率高，总存活率低，差异有统计学意义。总之，胆汁抗原阳性的肝细胞癌起源于更原始的细胞，比胆汁抗原阴性的肝细胞癌更具侵袭性。
In order to classify the hepatocellular carcinomas (HCCs) which had diverse clinicopathologic characteristics, we divided HCCs into two groups according to the expression of biliary antigen on the basis of the hypothesis that the hepatocyte and biliary epithelial cell originate from the same precursor cell, and then we investigated the clinical and pathologic characteristics in the two groups. Forty HCC cases with no preoperative treatment and at least two-year follow-up data were selected among 202 cases of HCC files from 1991 to 1995. Expression of biliary antigen (AE1, cytokeratin 19), p53, AFP, and Ki-67 in the tumor tissue were assessed by immunohistochemistry. Positive cytokeratin 19 was noted in one case (2.5%); AE1 was detected in 40% of patients; p53 was overexpressed in 20% of patients; and AFP was detected in 45% of patients. No statistical difference between the biliary antigen positive group (16 cases) and the negative group (24 cases) were noted in terms of mean age, sex, presurgical serum AFP level, Child class, and tumor size. HBsAg positive race was 66.7% for the biliary antigen (-) group and 93.8% for the biliary antigen (+) group with a statistically significant difference (p=0.048). The number of cases for Edmonson-Steiner grade I/II and III/IV were 15 and 9 in the biliary antigen (-) group, and 4 and 12 in the biliary antigen (+) group, respectively, with a statistically significant difference (p=0.024). The 1, 3 and 5-year disease-free survival races were 69.7, 40.9 and 40.9% for the biliary antigen (-) group and 73.7, 39.1, 39.1% for the biliary antigen (+) group with no statistically significant difference. The 1, 3 and 5-year overall survival rates were 91.7, 73.8, 66.4% for the biliary antigen (-) group and 68.8, 34.4, 34.4% for the biliary antigen (+) group, with a significantly greater overall survival rate for the biliary antigen negative group (p=0.045). Poor histopathological differentiation, a high HBsAg positive rate and poor overall survival rate were noted in the biliary antigen positive group and the differences were statistically significant. In conclusion, HCCs with positive biliary antigen, which originates from more primitive cells, is suggested to he more aggressive than HCCs with negative biliary antigen.