目的 探讨T-钙黏蛋白在肝癌肝移植患者癌组织和癌旁组织中的表达及其与肿瘤复发转移的关系。方法 收集解放军联勤保障部队第九〇〇医院2003年1月-2012年12月行原位肝移植手术的183例肝细胞癌（HCC）患者的临床资料，以符合肝癌肝移植米兰标准，且被切除肝脏的癌旁组织无微小血管侵犯（MVI）的76例患者为研究对象。根据术后随访中肿瘤是否复发转移分为复发转移组和无复发转移组，采用免疫组化法检测T-钙黏蛋白基因，观察其在两组患者癌组织和癌旁组织中的表达，比较术后5年内出现复发转移患者与未出现复发转移患者癌组织中T-钙黏蛋白基因的表达差异。结果 纳入的76例患者5年总复发转移率为21.05%，其中无MVI的患者46例（60.52%），术后肝癌复发转移率为17.39%；肝癌组织中细胞膜T-钙黏蛋白阳性表达率降低，缺失和异常表达明显升高，占47.83%，而癌旁组织缺失及异常表达较少见，仅占6.52%；两组相比差异具有统计学意义（χ²=19.828，P=0.000）；在出现复发转移的肝癌肝移植患者中癌组织T-钙黏蛋白异常表达（100%）与未复发转移的肝癌肝移植患者的（36.84%）相比差异有显著的统计学意义（χ²=10.565，P=0.001）。结论 T-钙黏蛋白基因在HCC中缺失和异常表达率较高，且与肝移植术后肝细胞癌的复发转移密切相关，有可能作为判断HCC肝移植预后的预测指标和药物干预的靶点。

Objection To investigate the difference of T-cadherin expression level between cancer and corresponding non-cancerous tissues in hepatocellular carcinoma (HCC) patients undergoing liver transplantation and the relationship between T-cadherin and tumor recurrence and metastasis. Methods A total of 183 patients who received liver transplantation for HCC at 900th Hospital of PLA from January 2003 to December 2012 were enrolled in this study, and 76 patients who met Milan Criteria For Liver Transplantation and had no microvascular invasion (MVI) in the para-carcinoma tissues were included. The patients were divided into two groups:recurrence & metastasis group and no recurrence & metastasis group, based on five years of follow-up after operation. The expression differences of T-cadherin between cancer and corresponding non-cancerous tissues of the two groups were observed, and within five years later after surgery, the expression differences of T-cadherin gene were compared with recurrence & metastasis and those without recurrence & metastasis in the cancer tissues of patients. Results The five-year cumulative recurrence and metastasis rate was 21.05% in 76 patients who met the Milan Criteria for liver transplantation of HCC, among which no MVI were 46 patients (60.52%), and the recurrence and metastasis rate was 17.39%. The rate of T-cadherin gene expression was low in cancer tissues, but its abnormal expression and deletion rate was up to 47.83%, which was significantly higher than that (6.52%) in the para-carcinoma tissues. The difference between the two groups was statistically significant (χ²=19.828, P=0.000). The T-cadherin abnormal expression rate of the recurrence & metastasis group (100%) was significantly different from that in the no recurrence & metastasis group (36.84%) (χ²=10.565, P=0.001) in cancer tissues. Conclusions The abnormal expression and deletion of Tcadherin gene in cancer tissues is closely related to the recurrence and metastasis of HCC after liver transplantation, and T-cadherin gene may be used as a prognostic indicator and drug research target for HCC patients undergoing liver transplantation.

R969.3

福建省自然科学基金（2016J01590），福建省社会发展引导性重点项目（2016Y0068），福建省科技创新联合基金（2016Y9063）