Objective:To evaluate the prognosis value of cofilin 1 in hepatocellular carcinoma(HCC).Methods:A total of 126 postoperative specimens of the patients who were diagnosed as HCC and accepted resection in Zhongshan Hospital from December 2012 to May 2014 were collected in this study.The expression of cofilin 1 in specimens were detected by immunohistochemistry and ranked.The correlation between cofilin 1 and other clinical characteristics was analyzed.The GraphPad software was used to do survival analysis for the cofilin 1-low group and cofilin 1-high group in order to determine their impact on the disease free survival(DFS)and overall survival(OS).The risk factors of recurrence and survival after HCC resection were analyzed by Cox proportional hazard regression model.Results:The score of cofilin 1 expression was proved to be weakly positive correlated to preoperative AFP,tumor size,and BCLC grade(P<0.05).The survival analysis showed the statistically significant difference(both P<0.05)of the postoperative OS and disease free survival time between cofilin 1-high group and cofilin 1-low group;they were the same in the BCLC grade 0/A(both P<0.05)and tumor size<5 cm sub-group(both P< 0.05),but not statistically significant in AFP ≤20 ng/mL sub-group and no invasion sub-group.The single factor analysis of Cox proportional hazard regression model showed that the level of cofilin 1 was valuable in the judgment of postoperative recurrence and survival(both P<0.05).The homologous multiple-factor analysis showed that cofilin 1 was an independent risk factor for postoperative recurrence(HR=1.647,95% CI 1.015-2.672)and survival(HR=2.412,95% CI 1.696-4.940)of the patients with HCC.Conclusions: The expression level of cofilin 1 has significant correlation to the postoperative recurrence and poor survival.The high expression level of cofilin 1 is an independent risk factor for the postoperative recurrence of HCC,which can be used to assess the prognosis of patients with HCC resection.%目的:探讨丝切蛋白1(cofilin 1)对原发性肝细胞肝癌(hepatocellular carcinoma,HCC)预后判断的价值.方法:收集2012年12月至2014年5月诊断为 HCC且在复旦大学附属中山医院接受 HCC切除术患者术后肿瘤组织标本126例.采用免疫组织化学染色检测肿瘤组织中 cofilin 1的表达,分析cofilin 1表达水平与肿瘤患者临床指标的相关性.采用GraphPad软件分析cofilin 1表达水平与患者术后复发与生存时间的相关性.采用Cox回归风险比例模型分析 HCC切除术后复发的相关危险因素.结果:Cofilin 1免疫组织化学染色评分与术前甲胎蛋白(α-fetoprotein,AFP)、肿瘤大小及巴塞罗那临床肝癌分组方案(BCLC分期)正相关(P<0.05,R<0.3).生存曲线分析显示:cofilin 1高表达组、低表达组患者术后无病生存时间、总生存时间差异均有统计学意义(P<0.05);不同BCLC分期和肿瘤大小 HCC患者间术后无病生存时间、总生存时间差异均有统计学意义(P<0.05),而不同AFP水平和侵袭发生与否患者亚组间术后无病生存时间、总生存时间差异无统计学意义.Cox回归风险比例模型的单因素分析发现:cofilin 1表达水平对患者术后复发和生存情况均有预测价值(P<0.05);多因素分析显示:cofilin 1是HCC患者行切除术后复发的独立危险因素(HR=1.647,95% CI 1.015~2.672),也是术后生存的独立危险因素(HR=2.412,95% CI 1.696~4.940).结论:Cofilin 1高表达与 HCC患者术后复发及较短生存时间相关,是肝癌术后复发的独立危险因素,可用于评估 HCC切除术后患者的预后.
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