摘要
背景:在出现以高度炎症(肝硬化)的基础的上,肝细胞癌(原发性肝癌)将在肝脏中发生。治疗方案的选择是有限的,主要是基于系统性的治疗,如抗血管生成药物(如索拉非尼)。结缔组织生长因子(CTGF)是一个细胞基质蛋白参与炎症、肿瘤生长和血管生成。本研究的目的是确定CTGF和缺氧诱导因子(HIF)在肝癌组织中的表达及对复发和生存的影响。 材料与方法:本研究入选标准包括诊断为HCC的患者,福尔马林固定石蜡包埋(FFPE)组织活检,以及复发和生存数据。利用大于70%肿瘤切片构建组织芯片。进行免疫组织化学分析CTGF、HIF1α和HIF2α的表达。分析了结缔组织生长因子/HIF1α、CTGF / HIF2α表达之间的关系。开展了单因素和多因素的分析。 结果:筛选出53例患者,其中39例患者均符合这项研究。患者均接受根除性治疗。在最后的随访,59%例复发(28.2%局部,10.3%例肝复发和远处转移7.7%)。估计的中期无病生存率(DFS)和总生存(OS)分别为23.4个月(95% CI 7.18-39.66)和38.6个月(95% CI 30.7-46.6)。CTGF表达:负23.1%,48.7%和23.1%局灶性弥漫性。CTGF和HIF表达之间无显著关系,显示了在肝癌组织中CTGF表达的另一种途径。在多变量分析中CTGF的表达与OS之间是一个独立因素,与局灶性或弥漫结缔组织生长因子表达的患者具有更短的生存期(HR 2.46;95% CI 1.18-5.15)。 结论:我们的研究结果说明在HCC中CTGF表达与较短的OS是一个独立因素。需要进一步分析更多样本的肝癌患者的CTGF的表达来证实CTGF可作为肝癌预后的生物标志物。
关键词: 结缔组织生长因子(CTGF),肝细胞癌(HCC),缺氧诱导因子(HIF),生存,治疗。
图形摘要
Current Cancer Drug Targets
Title:Tumoural Expression of Connective Tissue Growth Factor (CTGF) Impacts on Survival in Patients Diagnosed with Hepatocellular Carcinoma (HCC)
Volume: 15 Issue: 5
Author(s): Angela Lamarca, Marta Mendiola, Elsa Bernal, Victoria Heredia, Esther Díaz, María Miguel, Laura G. Pastrian and Emilio Burgos, Jaime Feliu and Jorge Barriuso
Affiliation:
关键词: 结缔组织生长因子(CTGF),肝细胞癌(HCC),缺氧诱导因子(HIF),生存,治疗。
摘要: Background: Hepatocellular carcinoma (HCC) tends to develop in the liver when there is a high level of background inflammation (cirrhosis). Treatment options are limited and mainly based on systemic therapies such as anti-angiogenic drugs (e.g. sorafenib). Connective tissue growth factor (CTGF) is a matricellular protein involved in inflammation, tumour growth and angiogenesis. The aim of this study is to determine the expression of CTGF and hypoxia inducible factors (HIF) in HCC and to clarify its impact on relapse and survival.
Material and Methods: Eligibility criteria for the study consisted of patients with a diagnosis of HCC, formalin-fixed and paraffin-embedded (FFPE) biopsy tissue, as well as relapse and available survival data. A tissue microarray was constructed from ≥70% tumoural sections. The expressions of CTGF, HIF1α and HIF2α were analysed by immunohistochemistry. The relationship between expression of CTGF/HIF1α and CTGF/HIF2α were analysed. Univariate and multivariate analyses were performed.
Results: Fifty-three patients were screened; 39 patients were eligible for this study. Patients were treated with radical intent. At the end of follow up, 59% patients relapsed (28.2% locally, 10.3% multicentric liver relapse and 7.7% distant metastases). Estimated median disease-free survival (DFS) and overall survival (OS) were 23.4 (95%CI 7.18-39.66) and 38.6 months (95%CI 30.7-46.6), respectively. Expression of CTGF was: negative 23.1%, focal 48.7% and diffuse 23.1%. A non-statistically significant relationship between expression of CTGF and HIF was shown supporting an alternative pathway for CTGF expression in HCC. In multivariate analysis CTGF expression was an independent factor related to OS, with shorter survival in those patients with focal/diffuse CTGF expression (HR 2.46; 95%CI 1.18-5.15).
Conclusions: Our results support that expression of CTGF is an independent factor associated with shorter OS in HCC. Further analysis of CTGF expression in a larger series of HCC patients is required to confirm CTGF as a prognostic biomarker in HCC.
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Angela Lamarca, Marta Mendiola, Elsa Bernal, Victoria Heredia, Esther Díaz, María Miguel, Laura G. Pastrian and Emilio Burgos, Jaime Feliu and Jorge Barriuso , Tumoural Expression of Connective Tissue Growth Factor (CTGF) Impacts on Survival in Patients Diagnosed with Hepatocellular Carcinoma (HCC), Current Cancer Drug Targets 2015; 15 (5) . https://dx.doi.org/10.2174/1568009615666150407124747
DOI https://dx.doi.org/10.2174/1568009615666150407124747 |
Print ISSN 1568-0096 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5576 |
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