目的:研究乙肝病毒/黄曲霉毒素B1双暴露相关性肝细胞性肝癌(hepatocellular carcinoma,HCC)染色体遗传学畸变的特点。方法将32例手术切除经病理证实为HCC的癌组织,按照乙肝病毒与黄曲霉毒素的暴露情况分为4个亚组:A组为HBV(+)/AFB1(+)10例;B组为HBV(+)/AFB1(-)10例;C组为HBV(-)/AFB1(+)6例;D组为HBV(-)/AFB1(-)6例。应用微阵列比较基因组杂交技术(Array CGH)检测分析其22对染色体DNA拷贝数的变化。结果32例HCC样本中,共发现573个染色体畸变区段(chromosomal aberrations,CNAs)。其中1q、4p、5p、6p、7p、8q、10p、17q、20p、20q和X主要表现为扩增区段;1p、2q、4q、8p、9p、10q、11q、13q、14q、16p、16q、17p、19p、19q、21q、22q和Y主要表现为缺失区段。同时,共检测出25个染色体发生高频畸变的区段(recurrently altered regions,RARs),其中1q21.1-q44、5p13.2-p15.3、6p12.1-p25.2、7q11.2-q35、8q11.2-q24.3、17q12-q25.2、18q12.3-q22.3和 X 为高频率扩增区段,而1p31.1-p36.2、2q23.2-q37.2、4q12-q35.2、6q14.1-q26、8p12-p23.2、9p21.1-p24.2、10q21.3-q26.2、13q12.1-q21.1、14q21.3-q32.2、16p12.1-p13.2、16q12.1-q24.1、17p12-p13.3、19p13.1-p13.3、19q13.2-q13.4、21q21.3-q22.2、22q11.2-q13.2和Y染色体为高频缺失区段。8p12-p23.2缺失的发生率在进展期HCC(TNM分期为Ⅲ~Ⅳ期)中明显高于早期HCC (TNM分期为I~II期)(P=0.038)。4q12-q35.2、13q12.1-q21.1的缺失及7q21.1-q35的扩增发生率在A组中最高。Cox模型分析结果示:在单因素分析中AFP水平、肿瘤大小、TNM分期、BCLC分期、侵袭与转移的发生、8p12-p23.2的缺失以及19p13.1-p13.
Objective To investigate genetic changes in individuals that may influence development of hepatocellular carcinoma (HCC)associated with hepatitis B virus (HBV)and exposure to aflatoxin B1 (AFB1). Method Patients with HCC were divided into four groups based on HBV infection and AFB1 exposure status:HBV(+)/AFB1(+),n=10;HBV(+)/AFB1(-),n=10;HBV(-)/AFB1(+), n=6;HBV(-)/AFB1(-),n=6.Array-based comparative genomic hybridization(Array CGH)was carried out on tumor tissue to identify genome-wide genetic changes. Result Among all 32 tissue samples,573 CNAs were identified,comprising 184 gains and 389 losses. Frequent gains were observed in the following regions:1q,4p,5p,6p,7p,8q,10p,17q,20p,20q and X.Frequent losses were observed in the following regions:1p,2q,4q,8p,9p,10q,11q,13q,14q,16p,16q,17p,19p,19q,21q,22q and Y.A total of 25 RARs were de-tected:8 RAR gains were 1q21.1-q44,5p13.2-p15.3,6p12.1-p25.2,7q21.1-q35,8q11.2-q24.3,17q12-q25.2,18q12.3-q22.3 and X;17 RARs losses were 1p31.1-p36.2,2q23.