HBV相关肝细胞癌组织GLAST、GS蛋白表达及其与切除术后早期复发转移的关系-东南大学学报医学版

HBV相关肝细胞癌组织GLAST、GS蛋白表达及其与切除术后早期复发转移的关系

单位：河南科技大学第一附属医院肝胆外科, 河南洛阳 471000

分类号：R735.7;R512.63

出版年·卷·期（页码）：2024·43·第二期（236-242）

摘要：

目的: 检测乙型肝炎病毒(HBV)相关肝细胞癌组织兴奋性氨基酸转运体1(GLAST)、谷氨酰胺合成酶(GS)蛋白表达,并分析其与切除术后早期复发转移的关系。方法: 选取本院2020年3月至2022年5月收治的125例实施切除术的HBV相关肝细胞癌患者,采用免疫组化法检测癌组织和切缘正常组织GLAST、GS蛋白表达。比较癌组织与切缘正常组织GLAST、GS蛋白阳性率;比较不同临床病理特征患者癌组织GLAST、GS蛋白阳性率;随访1年,Cox回归分析复发转移的影响因素。结果: 癌组织GLAST、GS蛋白阳性率分别为28.57%、73.95%,前者低于切缘正常组织的57.98%,后者高于切缘正常组织的33.61%(P＜0.05);HBV感染病程＞22年患者癌组织GLAST蛋白阳性率均低于＜10年、10~22年患者(P＜0.05);肿瘤淋巴结转移(TNM)Ⅲ~Ⅳ期、有门静脉癌栓、未/低分化患者癌组织GLAST蛋白阳性率低于TNM Ⅰ~Ⅱ期、无门静脉癌栓、中/高分化患者(P＜0.05),GS蛋白阳性率趋势相反;术后早期复发转移发生率为21.01%;年龄(HR=1.471,95%CI 1.086~1.993)、伴肝硬化(HR=1.728,95%CI 1.110~2.691)、GLAST蛋白阳性表达(HR=0.451,95%CI 0.224~0.910)、GS蛋白阳性表达(HR=2.255,95%CI 1.027~4.948)均是患者术后早期复发转移的影响因素(P＜0.05)。结论: HBV相关肝细胞癌组织GLAST蛋白阳性率降低、GS蛋白阳性率升高,且二者均与切除术后早期复发转移有关。

Objective: To detect the expression of excitatory amino acid transporter 1(GLAST) and glutamine synthetase(GS) protein in hepatitis B virus(HBV) associated hepatocellular carcinoma(HCC) and analyze on their relationships with early recurrence and metastasis after resection. Methods: 125 patients with HBV associated HCC underwent resection surgery in our hospital from March 2020 to May 2022 were selected. After surgery, the expression of GLAST and GS protein in cancer tissue and normal tissue at the cutting edge was detected using immunohistochemistry. The positive expression rates of GLAST and GS protein between cancer tissue and normal tissue at the cutting edge were compared. The positive expression rates of GLAST and GS proteins in cancer tissues of patients with different clinical and pathological characteristics were compared. After following-up for 1 year, Cox regression analysis of influencing factors for recurrence and metastasis were conducted. Results: The positive expression rates of GLAST and GS protein in cancer tissue were 28.57% and 73.95%, respectively. The former was lower than 57.98% of normal tissue at the cutting edge, while the latter was higher than 33.61% of normal tissue at the cutting edge(P<0.05). The positive expression rate of GLAST protein in cancer tissue of patients with HBV infection over 22 years was lower than those of patients with HBV infection less than 10 years, 10-22 years(P<0.05). The positive expression rates of GLAST protein in cancer tissues of tumor node metastasis(TNM) Ⅲ-Ⅳ stage, patients with portal vein tumor thrombus, and undifferentiated/poorly differentiated patients were lower than those of TNM Ⅰ-Ⅱ stage, patients without portal vein tumor thrombus, and patients with medium/high differentiated(P<0.05), and the trend of GS protein positive rates was opposite. The incidence of early postoperative recurrence and metastasis was 21.01%. Age(HR=1.471, 95%CI 1.086-1.993), accompanied by cirrhosis(HR=1.728, 95%CI 1.110-2.691), positive expression of GLAST protein(HR=0.451, 95%CI 0.224-0.910), and positive expression of GS protein(HR=2.255, 95%CI 1.027-4.948) were all influencing factors for early postoperative recurrence and metastasis in patients(P<0.05). Conclusion: The positive expression rate of GLAST protein in HBV associated HCC tissue is low, while the positive expression rate of GS protein is high, and both are related to early recurrence and metastasis after resection.

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