| Objective To explore the diversity of FXYD3 protein expression and thecorrelation with the clinical pathological characteristics in patients with primary liver carcinoma and to analyze the correlation of T regulatory cells level withhepatocellular carcinoma growth and tumor biological characteristics, and to investigate the safety and efficacy of surgical scheme planned and guided by CT guided three-dimensional reconstruction technology in hepatectomy.Methods 1)using western blot and immunohistochemistry technique to obtain the level of FXYD3 expression in hepatocellular carcinoma tissues, adjacent tissues and normal liver tissues, to analyze the clinical significance of the expression of FXYD3 protein and its relationship with tumor pathological characteristics.2) investigating the expression of regulatory T cells in peripheral blood of patients with PLC defected by flow cytometry 3) applying 3D reconstruction technique to obtain accurately the three-dimensional image of liver, liver neoplasms and internal important piping structure (hepatic artery, portal vein and hepatic vein), by which the preoperative surgical procedures and intraoperative tumor resection can be conducted precisely. And then analyzing intraoperative and postoperative complications based on this 3D technique.Results 1) FXYD3 was mainly expressed as brown granules in the cell membrane and cytoplasm of normal liver cells, and the expression level was decreased in adjacent tissues as light-brown and scattered granules. The expression level in hepatocellular carcinoma tissue was weakly positive or negative. In this study, the expression level of FXYD3 increased gradually in hepatocellular carcinoma tissues, adjacent tissues and normal liver tissue in turn(26.6%, 48.4%, 82.8%), and the difference was statistically significant (P<0.05). The expression level of FXYD3 in hepatocellular carcinoma was significantly lower than the adjacent tissues and normal liver tissues (P<0.05).Correlation analysis indicated that histological grading was positively correlated with the expression of FXYD3 in hepatocellular carcinoma tissues, that is, differentiation degree is worse, the lower the FXYD3 expression (P<0.05). The FXYD3 positive expression rate in patients with intrahepatic or extrahepatic metastasis is lower than patients without metastasis (P<0.05).In this study, 60 cases were followed up, the follow-up rate was up to 93.8%, and the median survival time was about 38 months.The 3-month, 6-month and 12-month survival rates of the patients were 100%, 98%and 90%, respectively. In addition, univariate analysis of prognostic factors showed that the level of FXYD3 protein, the degree of pathological differentiation and the intrahepatic or extrahepatic metastasis were the risk factors for the prognosis of patients with PLC.2) compared with healthy individual, the expression level of regulatory T cells in peripheral blood of patients with PLC increased significantly, and the difference was statistically significant (P < 0.05). In hepatocellular carcinoma group, the expression level of regulatory T cells is obviously lower in high AFP group than the medium/low AFP group, but the difference was not statistically significant (P >0.05). In addition, the regulatory T cells of high level expression have a significant inhibitory effect on effector T cells with negative correlation statistically. Survival analysis indicated that the survival time of patients with high level regulatory T cells was significantly shorter than patients with low expression (P < 0.05). Asits change trend was positively correlated with AFP, the expression level of regulatory T cells can be used as a marker for early diagnosis of tumor. 3) Based on 3D CT reconstruction and 3D reconstruction technique, the liver tumor location can be accurately and clearly displayed including the anatomic variation of hepatic artery, portal and hepatic vein and the spatial relationship between the tumor and these important pipeline structures.Among 20 cases undergoing 3D reconstruction, 16 cases(80%)were classified as hepatic artery type ? (normal), and 4 cases have hepatic arterial variation (20%). 14 cases were classified as portal vein type ? (70%), 3 cases were type ? (15%), 2 cases were type ? (10%) and 1 cases was type IV (5%). 18 cases (90%) were classified as hepatic vein type ? (normal type), 2 cases were type ? (10%). This study demonstrated that intraoperative blood loss was 187± 14ml and liver resection time was 13±5min in experimental group, 301 ±27ml and 21 ±7min respectively in control group. The differences were statistically significant (P<0.05), There was no significant difference between the two groups about postoperative complications rates (P > 0.05).Conclusion 1) The expression level of FXYD3 protein was significantly lower in hepatocellular carcinoma tissues than in normal liver and paracancerous tissues. The expression of FXYD3 protein in patients with hepatocellular carcinoma was correlated with histological grade and intra/extra-hepatic metastasis. FXYD3 can be used as a prognostic marker for patients with hepatocellular carcinoma. 2)Regulatory T cells were highly expressed in peripheral blood of patients with PLC, which has obvious inhibitory effect on effector T cells and is associated with serum AFP level positively.So it can be used as early diagnosis indicators of hepatocellular carcinoma. 3) The spatial location of tumor, liver anatomical structure and its variation can be displayed clearly and accurately by 3D reconstruction technology which has the advantages of precise guidance for surgical procedures development pre /intraoperation, reducing surgical bleeding and the operation time. So it makes radical resection of hepatocellular carcinoma safer and more effective, worthy of further clinical application. |
PDF Full Text Request