【摘要】 背景:人类白细胞抗原G由非经典人类白细胞抗原Ⅰ类基因,其参与多种病理生理过程,尤其在肿瘤免疫逃逸中发挥重要作用,可能是肿瘤复发及转移的重要机制之一。目的:探讨人类白细胞抗原G在肝细胞肝癌组织中的表达及其在肝癌肝移植患者预后中的价值。方法:回顾性分析109例肝癌肝移植病例的临床资料,应用免疫组化方法检测其切除的肝癌组织和癌旁肝组织中人类白细胞抗原G的表达情况,并对患者进行移植后随访。应用Kaplan-Meier法计算累积生存率和无瘤生存率,采用Log-rank检验和Cox回归模型分别进行无瘤生存率单因素、多因素分析。结果与结论:肝癌组织有77例人类白细胞抗原G阳性表达,癌旁组织中20例。人类白细胞抗原G表达与肝癌直径(P<0.05)、病理分级(P<0.05)、血管侵犯显著相关性(P<0.05)。单因素分析显示人类白细胞抗原G表达(P<0.01)是影响肝癌肝移植后无瘤生存率的危险因素。Cox风险回归模型多因素分析发现,人类白细胞抗原G表达(P<0.05)是影响肝癌肝移植患者后无瘤生存率的独立危险因素。肝癌组织存在人类白细胞抗原G表达。人类白细胞抗原G表达是影响肝癌肝移植患者移植后无瘤生存率的独立危险因素。对人类白细胞抗原G表达患者采取干预治疗及严格筛选肝癌肝移植的适应证及可有效降低移植后肿瘤的复发率。更多还原

【Abstract】 BACKGROUND: Human leukocyte antigen-G is a kind of nonclassical human leukocyte antigen Ⅰ gene, which has participated in a variety of pathophysiological processes, especially plays an important role in tumor immune escaping. In addition, it may be one of the mechanisms underlying tumor recurrence and metastasis. OBJECTIVE: To investigate the expression of human leukocyte antigen-G in hepatocellular carcinoma and its significance in the prognosis of liver transplantation in patients with hepatocellular carcinoma. METHODS: The clinical data of 109 patients who had undergone liver transplantation for hepatocellular carcinoma were analyzed retrospectively. The expression of human leukocyte antigen-G in the hepatocellular carcinoma tissue and liver tissue around the hepatocellular carcinoma tissue was detected with immunohistochemical method. The postoperative follow-up was performed. The Kaplan-Meier method was used to calculate the cumulative survival rate and tumor-free survival rate. Log-rank test and Cox regression model were used to analyze the single and multi-factor for tumor-free survival rate respectively. RESULTS AND CONCLUSION: The positive expression of human leukocyte antigen-G in tumor tissues was detected in the hepatocellular carcinoma tissue of 77 cases and in the surrounding tissues of 20 cases. A significant association was found between the expression of human leukocyte antigen-G and preoperative size of tumor (P < 0.05), vascular invasion (P < 0.05), and pathological differentiation (P < 0.05). Single factor analysis showed that expression of human leukocyte antigen-G (P < 0.01) was the risk factors that could affect the tumor-free survival rates of hepatocellular carcinoma after liver transplantation. Cox regression model analysis showed that expression of human leukocyte antigen-G (P < 0.05) was the independent risk factors of tumor-free survival rate. Human leukocyte antigen-G was highly expressed in hepatocellular carcinoma. The expression of human leukocyte antigen-G in hepatocellular carcinoma tissues was the independent risk factor of tumor-free survival rate of liver transplantation patients for hepatocellular carcinoma. Interventional treatment for human leukocyte antigen-G positive patients and strict selection of indication of liver transplantation for hepatocellular carcinoma can reduce the rate of tumor recurrence.更多还原