【摘要】 目的 :研究原癌基因ras/ p2 1在肝细胞癌 (HCC)中表达的意义以及不同化疗栓塞方法对其表达的影响。 方法 :7种不同组织学类型的HCC共 98例 ,单纯手术治疗 5 7例 ,4种介入治疗后二期切除 41例。采用SABC免疫组化方法 ,检测各样本中ras/p2 1的表达 ,并与临床转移情况对照。结果 :ras/p2 1阳性和阴性者转移率分别为 75 .0 %、3 7.9% ( χ2=4.67,P <0 .0 5 ) ,介入治疗组及其A、B、C、D各组和单纯手术组 p2 1阳性率分别为 2 9.3 %、5 7.1%、2 5 .0 %、2 0 .0 %、2 7.3 %、61.4% (介入组分别与单纯手术组相比 ,χ2 值依次为 9.87、0 .0 4、3 .79、8.17、4.3 6,P值依次为 <0 .0 1、>0 .75、>0 .0 5、<0 .0 1、<0 .0 5 )。化疗栓塞使HCC各组织学类型及各病理分级ras/p2 1表达不同程度下降。介入组与单纯手术组转移率分别为 48.8%、5 6.1% ( χ2 =0 .5 2 ,P >0 .2 5 )。结论 :ras/ p2 1高表达可促进HCC转移 ,就ras/ p2 1而言 ,化疗栓塞可抑制HCC转移潜能 ,且碘油、无水乙醇、明胶海绵多材料联合化疗栓塞优于单一材料栓塞和单纯化疗。更多还原

【Abstract】 Objective:To study the significance of ras/p21 gene expression of hepatocellular carcinoma (HCC), and the effect of the different chemoembolizational treatment on ras/p21.Methods:Ninety-eight histopathologically verified HCC specimens were obtained. The patients were treated with surgical resection alone (57 cases) and second stage surgical resection after four kinds of chemoembolization (41 cases). Strept avidin biotin complex (SABC) immunohistochemical staining with multiclonal antibody against human ras/p21 was used to observe the p21 in all specimens. The experimental results were compared with the surgical and clinical findings.Results:The metastatic rate in p21(+) and (-) was 75.0% and 37.9% respectively (χ 2=12.63,P<0.05);29.3% of chemoembolization group,57.1% of only chemotherapy, 25.0% of chemotherapy combined with iodized oil,20.0% of chemotherapy combined with iodized oil and spongia gelatini absorbens (sga),27.3% of chemotherapy combined with ethanol, iodized oil and sga,61.4% of surgical resection alone were positive for p21 (interventional groups were compared with surgical resection alone,P<0.01,>75,>05,<0.01,< 0.05, respectively).The metastatic rate in interventional group and surgical resection alone was 48.8% and 56.1% respectively (P>0.05).Conclusion:The increased expression of ras/p21 would enhance metastasis of HCC. It could act as a prognosis predictive marker. With respect to ras/p21, chemoembolization could suppress the potential of metastasis of HCC.Combined chemoembolization with ethanol, iodized oil and sga is superior to only chemotherapy and/or embolization with single material.更多还原