Objective: To investigate epidermal growth factor receptor (EGFR) and thymidylate synthase (TS) expression in primary liver cancer, and analyze its clinicopathological features and prognostic significance. Methods: Immunohistochemistry was performed using EnVision method to detect EGFR and TS expression in 41 cases of liver cancer. Correlation coefficient between EGFR and TS was calculated by Spearman method. Fisher's exact probability method or χ(2) test was used to analyze the clinicopathological features of EGFR and TS. Kaplan-Meier method was used to calculate the survival rate of patients in conjunction with the log-rank test.COX proportional hazard regression model was used to analyze the prognostic factors of patients. ROC curve was used to analyze the predictive accuracy of EGFR and TS for prognosis. Results: The positive rates of EGFR and TS in liver cancer tissues were 34.15% and 39.02%, respectively. There was a positive correlation between EGFR and TS expressions, and the difference was statistically significant (P < 0.05). EGFR was associated with tumor size and tissue differentiation (P < 0.05) in HCC patients, whereas TS was associated with tissue differentiation (P < 0.05). There was no significant difference in prognostic effect of EGFR on survival rate (P > 0.05). TS prognostic effect on survival rate was statistically significant (P < 0.05). HR of EGFR was 0.210 with 95% CI, 0.052-0.852, P = 0.029; indicating that the risk of death in patients with negative EGFR was 0.210 times higher than that in patients with positive EGFR. HR of TS was 2.496, with 95% CI, 1.325-4.701, P = 0.005, indicating that the risk of death increased by 2.496 times with the same level of EGFR. The area under the EGFR curve was 0.553 and its approximate reference confidence interval was 95% (0.355, 0.751), indicating that EGFR was a risk factor for death and the area under the TS curve was 0.695, and its approximate reference confidence interval was 95% (0.513, 0.878), indicating that TS was a risk factor for death. Conclusion: EGFR and TS were equally expressed in primary liver cancer, and EGFR and TS expressions were positively correlated. EGFR and TS had an effect on the degree of tissue differentiation in patients with liver cancer. EGFR and TS were risk factors for prognosis, and TS may assist EGFR.
目的： 探讨表皮生长因子受体（EGFR）和胸苷酸合成酶（TS）在原发性肝癌中的表达，分析其对肝癌临床病理特征和预后的影响。 方法： 采用免疫组织化学Envision法检测41例肝癌患者癌组织中EGFR和TS的表达；采用Spearman法计算EGFR和TS的相关系数；采用χ(2)检验或Fisher确切概率法分析EGFR和TS与患者临床病理特征的关系；采用Kaplan-Meier法计算患者生存率并行Log-rank法检验；采用COX比例风险回归模型分析患者预后影响因素；采用ROC曲线分析EGFR和TS对患者预后的预测准确度。 结果： EGFR和TS在肝癌组织中的阳性率分别为34.15%、39.02%，EGFR和TS的表达呈正相关，差异有统计学意义（P < 0.05）。EGFR和肝癌患者的肿瘤大小、组织分化有关（P值均< 0.05）；TS和肝癌患者的组织分化有关（P < 0.05）。EGFR对患者生存率影响的差异无统计学意义（P > 0.05）；TS对患者生存率影响的差异有统计学意义(P < 0.05)。EGFR的HR = 0.210，95% CI为0.052～0.852，P = 0.029；表明TS相同时，EGFR阴性患者死亡的风险为阳性患者的0.210倍，EGFR是患者死亡的危险因素；TS的HR = 2.496，95% CI为1.325～4.701，P = 0.005；表明在EGFR相同时，TS每增加一级，患者死亡的风险增加2.496倍；TS是患者死亡的危险因素。EGFR曲线下面积为0.553，其95%的近似参考置信区间为（0.355，0.751），表明EGFR是患者死亡的危险因素；TS曲线下面积为0.695，其95%的近似参考置信区间为（0.513，0.878），表明TS是患者死亡的危险因素。 结论： EGFR和TS在肝癌癌组织中均有表达，且EGFR和TS的表达呈正相关；EGFR和TS均对肝癌患者的组织分化程度有影响；EGFR和TS是患者预后的危险因素，并且TS可能协助EGFR起作用。.
Keywords: Carcinoma, hepatocellular; Epidermal growth factor receptor; Prognosis; Thymidylate synthase.