The Study Of Mathematical Prediction Model On Multi-porptein、the Multi-factorlinked To Pulmonary Metastasis After Curative Hepatic Resection

Objective:To investigate the establishment of the mathematical prediction model linked topulmonary metastasis-associated protein and cinically relevant factors after curativehepatic resection.Methods:Totally279cases of HCC were chosen in our hospital from Jan.2008toJan.2011.Tissue microarrays was constructed,among this patients,36cases ofpulmonary metastasis,143cases of no pulmonary metastasis. the expression of P53、nm23、P27、uPA、HIF-1α、MMP-9、VEGF、β-catenin、E-cadherin、CK19、Survivin、TGFβ1、PCNAand CXCR7protein were evaluated by immunohistochemical methodin279HCC. The hepatocelluar carcinoma patients who received radical operationwere investigated retrospectively. A single factor analysis was performed to find therisk factors and protein of early pulmonary metastasis after curative hepatic resection.And a multivariate logistic regression analysis was performed according to therelevant clinical and pathology factors and pulmonary metastasis-associated protein toestablish the prediction equation of early pulmonary metastasis.Results:1. The ratio of pulmonary metastasis of hepatocelluar carcinoma after curative hepaticresection in1year was12.9%（36/279）.2. Tissues microarrays constructed manully had a very good puality By IHC,Themean fall rate was3.90%and the mean observation rate was100.00%.3. comparing with the para-carcinoma tissues,distant-carcinoma tissues and nomallive tissues,the expression of Survivin、CXCR7、PCNA、CK19、UPA、p53、MMP-9、VEGF、HIF-1α、β-catenin and E-cadherin protein in HCCs were significantlyincreased,while the expression of p27、nm23、TGFβ1protein were in HCCs werereduced.The expression of all markers showed difference in para-carcinomatissues,distant-carcinoma tissues and nomal live tissues. 4. comparision of pulmonary metastasis group and no occurrence of pulmonarymetastasis group,the expression of Survivin、PCNA、CK19、UPA、p53、MMP-9、VEGF、HIF-1α、β-catenin、p27、nm23、TGFβ1and E-cadherin protein in HCCs wereno statistically significant difference; the expression of CXCR7in HCCs werestatistically significant difference，so CXCR7is a risk factor for pulmonary metastasisof hepatocellular carcinima.5. According to single factor analysis, the indicators, including the tumor diameters,the CXCR7, the level of AFP, microvascular invasion by the microscope examinationwere different significantly in two groups. The multivariate logistic regressionanalysis indicated that the independent prognostic factors of pulmonary metastasisof hepatocelluar carcinoma after curative hepatic resection was the CXCR7, thetumor diameters and microvascular invasion by the microscope examination.Conclusions:1. tumor diameters, CXCR7, the level of AFP, microvascular invasion by themicroscope examination are the risk factor for pulmonary metastasis ofhepatocelluar carcinoma after curative hepatic resection.tumor diameters,CXCR7areindependent risk factor for pulmonary metastasis of hepatocelluar carcinoma aftercurative hepatic resection.2. To establish a multi-proptein、the multi-factor mathematical prediction modelpulmonary metastasis after curative hepatic resection is initially formed an individaulprediction system,which may be used to screen initially high-risk patient ofpulmonary metastasis,who can take early anti-pulmonary metastasis treatment.