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目的 探讨肝细胞癌增殖细胞核抗原 (PCNA)基因表达水平与肝亚段动脉化学栓塞疗效的相关性。方法 43例肝细胞癌患者在B型超声引导下行肝穿刺活检获取肝癌组织标本 ,并应用免疫组织化学方法以小鼠抗人PCNA单克隆抗体检测PCNA标记指数(PCNAlabelingindex ,PCNALI) ,观察肝癌组织PCNALI与肝亚段动脉化学栓塞疗效和预后的关系。采用的统计方法有方差分析 ,t检验 ,Kaplan -Meier法 ,Log -rank检验等 (SPSS 10 .0软件包 )。结果 肝亚段动脉栓塞治疗后 1～ 3年生存率分别为 86.0 5 %、65 .12 %、5 1.16% ,优于常规肝动脉化学栓塞治疗效果 (Ρ <0 .0 5 )。肝细胞癌穿刺组织平均PNCALI为 (68± 2 7) %。PCNALI随着Edmondson -Steiner分级级别的增加而表达水平增高。PCNA低表达患者生存率显著高于高表达者 (Ρ <0 .0 5 )。高分化肝细胞癌组织PCNALI与无瘤肝组织PCNALI比较无统计学意义。结论 肝亚段动脉栓塞治疗肝细胞癌副作用少 ,疗效优于常规化学栓塞治疗 ;肝细胞癌抗原PCNA是反映肝亚段动脉化学栓塞术预后的一个客观指标
Objective To investigate the relationship between the expression of proliferating cell nuclear antigen (PCNA) gene and the efficacy of hepatic sub-arterial chemoembolization in hepatocellular carcinoma (HCC). Methods Forty-three patients with hepatocellular carcinoma underwent hepatocellular biopsy under the guidance of B-mode ultrasonography. The expression of PCNA labeling index (PCNA) was detected by immunohistochemical method using mouse anti-human PCNA monoclonal antibody (PCNA) Relationship between Efficacy and Prognosis of Hepatic Artery Chemoembolization. The statistical methods used were analysis of variance, t test, Kaplan-Meier method, Log-Rank test (SPSS 10.0 package). Results The 1- and 3-year survival rates after hepatic sub-arterial embolization were 86.0%, 65.12% and 5.16%, respectively, which were better than those of conventional hepatic arterial chemoembolization (P <0.05). The average PNCALI of hepatocellular carcinoma was (68 ± 27)%. PCNALI increased with the increase of Edmondson-Steiner grade. The survival rate of patients with low PCNA expression was significantly higher than those with high expression (P <0.05). There was no significant difference between PCNALI and PCNALI in well-differentiated hepatocellular carcinoma. Conclusions Hepatic sub-arterial embolization is less effective than conventional chemoembolization in the treatment of hepatocellular carcinoma. PCNA is an objective index reflecting the prognosis of arterial chemoembolization