目的：探讨NRAGE在小肝细胞癌中的表达情况及其临床意义。方法：采用免疫组化技术检测160例原发性小肝细胞癌组织及配对癌旁非癌组织中NRAGE的表达，分析NRAGE表达与小肝细胞癌患者临床病理指标及预后的关系。结果：NRAGE在小肝细胞癌组织中阳性表达率明显高于配对癌旁组织（63.13% vs. 14.38%，P<0.05）。NRAGE表达增高与患者年龄、术前AFP水平、完整包膜和复发密切相关（均P<0.05）。单因素分析显示，微血管癌栓、术前AFP水平、子灶、完整包膜、复发、浆膜浸润、巴塞罗那分期、分化程度和NRAGE表达是小肝细胞癌患者的预后影响因素（均P<0.05）。多因素分析结果显示，NRAGE表达与微血管癌栓、术前AFP水平、复发、巴塞罗那分期是影响小肝细胞癌患者预后的独立危险因素（均P<0.05）。NRAGE高表达小肝细胞癌患者5年生存率明显低于低表达患者（35.63% vs. 54.23%，P<0.05）。结论：NRAGE在小肝细胞癌组织中表达增高，NRAGE高表达患者预后差。
NRAGE expression in small hepatocellular carcinoma and its clinical significance
Objective: To investigate the expression and clinical value of neurotrophin receptor-interacting melanoma antigen-encoding protein (NRAGE) in small hepatocellular carcinoma (HCC) and its clinical significance. Methods: The NRAGE expressions in 160 specimens of small HCC tissue with paired adjacent non-tumorous tissue were determined by immunohistochemical staining. The relations of NRAGE expression with clinicopathological features and prognosis of small HCC patients were analyzed. Results: The positive expression rate of NRAGE in small HCC tissue was significantly higher than that in adjacent tissues (63.13% vs. 14.38%, P<0.05). NRAGE expression was significantly related to age, preoperative AFP level, complete capsule and recurrence (all P<0.05). Univariate prognostic analysis showed that microvascular invasion, AFP level, childhood lesions, complete capsule, recurrence, serosal invasion, Barcelona stage, degree of differentiation and NRAGE expression were factors affecting the prognosis of small HCC patients (all P<0.05), and multivariate prognostic analysis showed that NRAGE expression together with microvascular invasion, preoperative AFP level, recurrence, and Barcelona stage were independent risk factors for prognosis of small HCC patients (all P<0.05). In addition, the 5-year survival rate of patients with high NRAGE expression was significantly lower than those with low NRAGE expression (35.63% vs. 54.23%, P<0.05). Conclusion: NRAGE expression is up-regulated in small HCC tissue, and patients with high NRAGE expression may have an unfavorable prognosis.