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中华肝脏外科手术学电子杂志 ›› 2021, Vol. 10 ›› Issue (03) : 326 -330. doi: 10.3877/cma.j.issn.2095-3232.2021.03.020

所属专题: 文献

基础研究

Cell-in-cell现象在肝细胞癌术后复发中的预测价值
邓铭彬1, 代天星1, 鲁旭1, 汪国营1,()   
  1. 1. 510630 广州,中山大学附属第三医院肝脏外科 肝移植中心
  • 收稿日期:2021-03-15 出版日期:2021-06-10
  • 通信作者: 汪国营
  • 基金资助:
    国家自然科学基金(81470870,81670601,81770648); 十三五科技重大专项(2017ZX10203205-006-001); 广东省自然科学基金(2016A030313278,2015A030313038,2015A030312013); 广东省科技计划项目(2014A020211015,2017B020209004); 广州市科技计划项目(2014J4100183)

Predictive value of cell-in-cell phenomenon for postoperative recurrence of hepatocellular carcinoma

Mingbin Deng1, Tianxing Dai1, Xu Lu1, Guoying Wang1,()   

  1. 1. Liver Transplantation Center, Department of Liver Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2021-03-15 Published:2021-06-10
  • Corresponding author: Guoying Wang
引用本文:

邓铭彬, 代天星, 鲁旭, 汪国营. Cell-in-cell现象在肝细胞癌术后复发中的预测价值[J/OL]. 中华肝脏外科手术学电子杂志, 2021, 10(03): 326-330.

Mingbin Deng, Tianxing Dai, Xu Lu, Guoying Wang. Predictive value of cell-in-cell phenomenon for postoperative recurrence of hepatocellular carcinoma[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2021, 10(03): 326-330.

目的

探讨cell-in-cell(CIC)现象在肝细胞癌(肝癌)术后复发中的预测价值。

方法

回顾性分析2014年1月至2019年8月中山大学附属第三医院行肝癌肝切除术的79例患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男69例,女10例;年龄26~78岁,中位年龄48岁。患者肿瘤组织切片行HE染色及E钙粘素免疫组化染色,计数肿瘤组织中CIC结构。肝癌与癌旁组织CIC计数比较采用秩和检验。生存分析采用Kaplan-Meier法和Log-rank检验。CIC对患者预后的影响采用Cox比例风险回归模型分析,根据独立影响因素绘制无复发生存的预测列线图。

结果

肝癌组织CIC计数中位数为16.3(10.3,21.7),明显高于癌旁组织中的3.0(2.0,4.3) (Z=7.722,P<0.05)。高CIC组和低CIC组肝癌肝切除术后患者1、3、5年无复发生存率分别为75.0%、46.7%、40.0%和85.9%、75.8%、62.0%,差异有统计学意义(χ2=4.866,P<0.05)。Cox多因素分析显示,癌组织高CIC计数≥16个为肝癌患者术后无复发生存的独立危险因素(OR=2.984,95%CI:1.185~7.515;P<0.05)。列线图显示,癌组织CIC计数≥16个时,其分值约为5.2分,影响能力仅次于有大血管侵犯及女性患者因素。

结论

肝癌组织中CIC计数升高,CIC计数是肝癌肝切除术后无复发生存的独立影响因素,CIC计数≥16个的患者复发率更高,预后更差。

Objective

To evaluate the predictive value of cell-in-cell (CIC) phenomenon for the postoperative recurrence of hepatocellular carcinoma (HCC).

Methods

Clinical data of 79 patients who underwent hepatectomy for HCC in the Third Affiliated Hospital of Sun Yat-sen University from January 2014 to August 2019 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 69 patients were male and 10 female, aged from 26 to 78 years with a median age of 48 years. The tumor tissues were collected for HE staining and E-cadherin immunohistochemical staining. The number of CIC structure in HCC tissues was counted. The number of CIC between the HCC tissues and adjacent tissues was statistically compared by rank-sum test. Survival analysis was performed by Kaplan-Meier method and Log-rank test. The influence of CIC on the prognosis of HCC patients was analyzed by Cox's proportional hazard regression model. The nomogram for predicting recurrence-free survival was delineated according to the independent influencing factors.

Results

The median quantity of CIC in HCC tissues was 16.3(10.3, 21.7), significantly higher than 3.0(2.0, 4.3) in the adjacent tissues (Z=7.722, P<0.05). The 1-, 3- and 5-year recurrence-free survival rates in the high CIC group were 75.0%, 46.7% and 40.0%, significantly lower compared with 85.9%, 75.8% and 62.0% in the low CIC group, respectively (χ2=4.866, P<0.05). Multivariate Cox's analysis showed that the quantity of CIC≥16 in HCC tissues was an independent risk factor for the recurrence-free survival of HCC patients after operation (OR=2.984, 95%CI: 1.185-7.515; P<0.05). The nomogram demonstrated that the risk score was approximately 5.2 when the CIC quantity in HCC tissues was ≥16, secondary to the risk factors of large vessel invasion and female patients.

Conclusions

The quantity of CIC is increased in HCC tissues, which is an independent risk factor affecting the recurrence-free survival of HCC patients after hepatectomy. HCC patients with a quantity of CIC ≥16 present with higher recurrence rate and worse clinical prognosis.

图1 肝癌组织光镜下cell-in-cell现象
表1 肝癌肝切除术后患者预后影响因素Cox回归分析
图2 肝癌患者无复发生存预测列线图
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