| Objective:To probe into the Ki67, VEGF, P53 expression and the relation with clinical pathological characteristics, and the prediction value of it for the recurrence and metastasis of HCC after liver transplantation in hepatic carcinoma. In this retrospective study, the survival influence of chemotherapy for these patients were studied.Methods:Using immunohistochemical method to detect of the expression of Ki67, VEGF and P53 in hepatic carcinoma after liver transplantation, collection of relevant clinical pathologic data and recurrence and metastasis time, and analyze its correlation with the molecules. Recurrence and metastasis after liver transplantation of hepatic carcinoma patients is divided into chemotherapy group and control group ccording to whether received chemotherapy, All patients underwent local therapy. collecting the appeared adverse reaction in process of chemotherapy, curative effect evaluation, disease progression time and death time, then, analyze the survival of patients.Results:1. The expression of Ki67 had significantly associated with number of tumor and degree of tumor differentiation (P< 0.05); The expression of VEGF had significantly associated with tumor diameter, number of tumor, tumor differentiation degree and lymph no,de metastasis (P < 0.05); The expression of P53 had significantly associated with Tumor capsular and diameter (P< 0.05).2. In 37 cases relapse group and 23 cases no recurrence group of liver cancer tissue samples, the positive expression rate of Ki67 is respectively 67.5%(25/37) and 39.1%(9/23); the positive expression rate of VEGF is respectively 56.7%(21/37) and 30.4%(7/23); the positive expression rate of P53 is respectively 62.1%(23/37) and 34.7%(8/23). The positive expression of Ki67/VEGF and P53 has significant difference between the relapse group and no recurrence group, also related to the recurrence and metastasis of tumor (P< 0.05).3.The single factor analysis of the expression of VEGF, Ki67,and P53 in liver tissue is associated with tumor recurrence after transplantation (P< 0.05), the multi-factor analysis showed that VEGF expression can independent foresee tumor recurrence and metastasis after liver transplantation in patients with liver cancer (P< 0.05), but Ki67 and P53 did not show independent forecasts significance (P> 0.05).4. In 20 patients with chemotherapy, recived PR 2 cases (10%), SD 10 cases (50%), PD 8 cases (40%), no patients for CR, RR was 10%, the DCR reached 60%.Major adverse reactions was neutropenia 45%(9/20), thrombocytopenia 25%(5/20), anemia 25%(5/20), nausea and vomiting 40%(8/20).5.The mPFS of chemotherapy group and control group were 3.0 months and 2.0 months, there was statistically significant difference between the two groups (P< 0.05); The mPFS of chemotherapy group and control group were 9.4 months and 4.9 months, there was no statistically significant difference between the two groups (P> 0.05).Conclusion:1. The expression of Ki67 had significantly associated with number of tumor and degree of tumor differentiation; The expression of VEGF had significantly associated with tumor diameter, number of tumor, tumor differentiation degree and lymph node metastasis; The expression of P53 had significantly associated with Tumor capsular and diameter.2. The expression of Ki67, VEGF and P53 in hepatic carcinoma tissue were correlation with tumor recurrence and metastasis after transplantation, but only the high VEGF positive expression in hepatic carcinoma tissue can independent predict the recurrence and metastasis of hepatic carcinoma after liver transplantation.3. The traditional chemotherapy to patients with recurrence and metastasis hepatic carcinoma after transplantation has good security.4. The effect of traditional chemotherapy Combined with local therapy treatment to cure the recurrence and metastasis of hepatic carcinoma after transplantation is better than the local therapy, chemotherapy can prolong patients’ PFS time and OS time, and the short-term curative effect is remarkable. |
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