摘要目的:研究细胞周期蛋白Y（CCNY）对肝癌患者病变程度的影响以及其与手术前后肝损伤的相关性。方法:回顾性分析2015年1月至2017年10月浙江省医疗健康集团杭州医院60例肝癌患者（肝癌组）、69例肝硬化患者（肝硬化组）的临床资料。肝硬化组Child-Pugh肝功能分级A级33例（肝硬化A级组），B级21例（肝硬化B级组），C级15例（肝硬化C级组）。采用全自动生化分析仪检测血清总胆红素（TBIL）、丙氨酸氨基转移酶（ALT）、白蛋白、胆碱酯酶、γ-谷氨酰转肽酶（GGT）和总胆汁酸；采用WB法检测血清CCNY，并与40例健康体检者（健康对照组）进行比较。结果:与健康对照组比较，肝硬化A、B、C级组白蛋白和胆碱酯酶明显降低，ALT、TBIL、GGT、总胆汁酸和CCNY明显升高，且随着肝脏病变程度越重变化越明显，差异有统计学意义（ P<0.05）。Pearson相关分析结果显示，肝癌患者CCNY与TBIL、ALT、总胆汁酸和GGT呈正相关（ r = 0.544、0.612、0.553和0.539， P<0.05），CCNY与白蛋白和胆碱酯酶呈负相关（ r = - 0.478和- 0.620， P<0.05）。肝癌患者术前及术后1、2、7 d CCNY分别为3.01 ± 1.10、7.24 ± 2.57、6.29 ± 1.78和4.01 ± 1.52，ALT分别为（98.74 ± 16.79）、（430.55 ± 197.62）、（255.73 ± 26.77）和（121.89 ± 20.42）U/L；术后1和2 d CCNY和ALT明显高于术前，术后2 d明显低于术后1 d，术后7 d明显低于术后2 d，差异均有统计学意义（ P<0.05）；术后7 d与术前比较差异无统计学意义（ P>0.05）。肝癌患者血清CCNY的表达与术前、术后1 d、术后2 d和术后7 d ALT呈正相关（ r = 0.669、0.821、0.663、0.642， P<0.01）。 结论:肝癌患者的肝脏病变程度越重患者血清CCNY越高，且CCNY的表达越高肝癌患者因手术肝损伤程度越重，其与肝损伤指标呈正相关。

abstractsObjective:To study the effect of cyclin Y (CCNY) on the lesion degree of patients with liver cancer and its correlation with preoperative and postoperative liver injury.Methods:The clinical data of 60 patients with liver cancer (liver cancer group) and 69 patients with liver cirrhosis (liver cirrhosis group) in Hangzhou Hospital of Zhejiang Medical and Health Group from January 2015 to October 2017 were retrospectively analyzed. In liver cirrhosis group, Child-Pugh liver function grade A was in 33 cases (liver cirrhosis grade A group), grade B was in 21 cases (liver cirrhosis grade B group), grade C was in 15 cases (liver cirrhosis grade C group). The serum total bilirubin (TBIL), alanine aminotransferase (ALT), albumin, cholinesterase, γ-glutamyl transpeptidase (GGT) and total bile acid were detected by automatic biochemical analyzer. The serum CCNY was detected by WB method, and compared with 40 healthy subjects (healthy control group).Results:Compared with those in healthy control group, the albumin and cholinesterase in liver cirrhosis grade A, B and C groups were significantly decreased, the ALT, TBIL, GGT, total bile acid and CCNY were significantly increased, , and the changes were more obvious with the severity of liver disease, and there were statistical differences ( P<0.05). Pearson correlation analysis result showed that the CCNY was positive correlation with TBIL, ALT, total bile acid and GGT in patients with liver cancer ( r = 0.544, 0.612, 0.553 and 0.539; P<0.05), and CCNY was negative correlation with albumin and cholinesterase ( r = - 0.478 and - 0.620, P<0.05). In patients with liver cancer, before operation and 1, 2 and 7 d after operation, the CCNY was 3.01 ± 1.10, 7.24 ± 2.57, 6.29 ± 1.78 and 4.01 ± 1.52, ALT was (98.74 ± 16.79), (430.55 ± 197.62), (255.73 ± 26.77) and (121.89 ± 20.42) U/L, respectively; the CCNY and ALT 1 and 2 d after operation were significantly higher than those before operation, those 2 d after operation were significantly lower than those 1 d after operation, those 7 d after operation were significantly lower than those 2 d after operation, and there were statistical differences ( P<0.05); there were no statistical difference between 7 d after operation and before operation ( P>0.05). The expression of CCNY before operation and 1 d, 2 d, 7 d after operation was positive correlation with ALT in patients with liver cancer ( r = 0.669, 0.821, 0.663 and 0.642; P<0.01). Conclusions:The more severe the degree of liver lesions in patients with liver cancer, the higher the serum CCNY, and the higher the expression of CCNY, the more severe the degree of liver injury in patients with liver cancer due to surgery, which is positively correlated with liver injury indexes.