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目的：研究 Ｈ Ｃ Ｃ 细胞凋亡、ｐ２１ 和 Ｐ Ｃ Ｎ Ａ 表达与临床预后的关系。方法：５５ 例 Ｈ Ｃ Ｃ 标本采用 Ｄ Ｎ Ａ末端标记（ Ｔｕｎｅｌ） 和免疫组化检测并结合计算机图像技术定量分析。结果： 小肝癌（ ＜ ５ ｃｍ） Ａ Ｉ高于大肝癌（ Ｐ＜００１） ，肝内转移、浸润性及低分化 Ｈ Ｃ Ｃ 的 Ａ Ｉ分别低于无转移（ Ｐ＜ ００１） 、非浸润性及高分化 Ｈ Ｃ Ｃ（ Ｐ＜ ００５） 。而 Ｐ Ｃ Ｎ Ａ Ｌ Ｉ恰好相反。癌旁组织ｐ２１ 阳性率及ｐ２１ 表达值（ Ｐ Ｕ） 均高于癌组织（ Ｐ＜ ００１） 。并且癌及癌旁组织ｐ２１ 表达值在浸润性及肝内转移 Ｈ Ｃ Ｃ 分别高于非浸润性及无转移 Ｈ Ｃ Ｃ（ Ｐ＜ ００１） 。 Ａ Ｉ 与 Ｐ Ｃ Ｎ Ａ Ｌ Ｉ 呈高度负相关（ｒ＝ ０７２８ ９ ， Ｐ＜ ００１） 。术后生存１ 年以上者其 Ａ Ｉ大于生存１ 年以内者（ Ｐ＜ ００１） ，而 Ｐ Ｃ Ｎ Ａ Ｌ Ｉ和ｐ２１ 表达值却小于生存１ 年以内者（ Ｐ＜ ００５） 。结论： Ａ Ｉ、 Ｐ Ｃ Ｎ Ａ Ｌ Ｉ和ｐ２１ 表达水平与 Ｈ Ｃ Ｃ 的分化、浸润、转移和预后密切相关，可能成为 Ｈ Ｃ Ｃ 预后判断的潜在指标。
Objective: To investigate the relationship between the apoptosis of HCC cells, the expression of p21 and PCNA and clinical prognosis. METHODS: A total of 55 HCC specimens were tested with D N A-end labeling (Tune) and immunohistochemical detection combined with computer image techniques for quantitative analysis. RESULTS: Small HCC (< 5 cm) had higher A I than large HCC (P<001). Intrahepatic metastasis, invasive and poorly differentiated H C C were lower than those without metastasis (P<001). Non-invasive and well-differentiated H C C (P < 005). However, P C N A-L I is just the opposite. The positive rate of p21 and the expression value of p21 (P U) in the adjacent tissues were higher than those in the cancer tissues (P < 0.01). In addition, the invasiveness and intrahepatic metastasis of p21 in cancer tissues and adjacent tissues were significantly higher than those of non-invasive and non-metastatic H C C (P < 0.01). There was a highly negative correlation between A I and P C N A-L I (r = 0728 9 , P< 001). Those who survived for more than one year after surgery had greater AI than those who survived within one year (P<001), while the expression values of P C N AL I and p21 were less than those within one year of survival (P<005). . CONCLUSIONS: The expression levels of A I, P C N A L I and p21 are closely related to the differentiation, invasion, metastasis, and prognosis of H C C and may be potential indicators of H C C prognosis.