| Objective:Hepatocellular carcinoma is one of the common malignant tumors in China.At present,there is still no effective treatment.The main treatment is surgical resection,but postoperative recurrence and metastasis is the main obstacle to improve the prognosis of patients.Therefore,the search for valuable indicators of hepatocellular carcinoma metastasis and recurrence can guide the early intervention of patients with highly recurrent hepatocellular carcinoma.CCL20 can induce hepatoma cell proliferation,inhibit cell apoptosis and increase cell survival,but the value of CCL20 in the prognosis of hepatocellular carcinoma patients is still unclear.The aim of this study was to investigate the expression characteristics of CCL20 in hepatocellular carcinoma and its value as an indicator of prognostic evaluation in order to provide a theoretical basis for early intervention in people with high recurrence risk.Methods:From October 2015 to February 2016,58 HCC patients who presented in the Second Affiliated Hospital of Soochow Universityy,Sihong People's Hospital were enrolled in the study.Real-time PCR was performed to test the expressions of CCL20 in cancer tissue and para-carcinoma tissue.The levels of serum CCL20 were detected on preoperative and postoperative days 3,7,14 in HCC patients using ELISA,and also the level of serum CCL20 when recurrence occurs.Clinical data of 58 HCC patients were collected prospectively and analyzed retrospectively.The relationships between CCL20 and clinical features were analyzed by using Mann-Whitney U test.By Western blot,we detected the expression of CCL20 and related proteins MAPK in two groups with or without recurrence.Overall survival and disease-free survival were calculated using Kaplan-Meier analysis.Statistical analysis of results was performed using SPSS 20.0 software.The experiment was repeated at least 3 times independently to ensure good reproducibility.The comparison between groups of data was analyzed by one-way ANOVA method.p<0.05 indicates that the difference was statistically significant.Results:The levels of serum CCL20 in HCC patients began to decrease in third day after surgery(103.98pg/ml vs 91.10 pg/ml,p<0.05),obviously one week and slowly in the second week.Compared with the expression in the second week after surgery,the level of serum CCL20 increased significantly when liver recurrence occurred(63.88pg/ml vs 104.43pg/ml,p<0.05),but it is not happened in pulmonary metastasis group(65.42pg/ml vs 61.34pg/ml,p>0.05).The expression of CCL20 was significantly higher in cancer tissue than that in para-carcinoma tissue(p<0.01)and correlated with primary tumor size,clinical stage,lymph node involvement(p<0.05).It's independent of the age,gender,cause of the disease,liver function,cirrhosis,number of tumors,vessel tumor embolus,and lung metastasis(p>0.05).According to follow-up,the expression of CCL20 in primary tumor was correlated with postoperative intrahepatic metastasis(p<0.05),and was not associated with lung metastasis.It showed that overall survival(25.9m vs 13.5m,p=0.002)and disease-free survival(16.7m vs 9.8m,p=0.003)of patients with low CCL20 expression in primary tumor were obviously better than those with high CCL20 expression.Further validated at protein level,patients with the higher the expression of CCL20 and MAPK in tumor had worse prognosis.Conclusion:The levels of serum CCL20 in HCC patients were decreased significantly after surgery.Compared with the expression in the second week after surgery,the level of serum CCL20 increased significantly when liver recurrence occurred,indicating that serum CCL20 expression is associated with proliferation and progression of hepatocellular carcinoma.The expression of CCL20 was correlated with primary tumor size,clinical stage,lymph node involvement.It is also found that it may be involved in proliferation and liver-specific metastasis.Higher expression of CCL20 in cancer tissue may be related to disease-free survival and overall survival.It may provide a new observed indicator for follow-up and prognosis evaluation of hepatocellular carcinoma. |
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