肝动脉化疗栓塞联合血管内皮抑素治疗肝癌的试验及临床应用研究

目的了解经肝动脉化疗栓塞术（TACE）联合血管内皮抑素（Endostar）治疗兔VX2肝癌模型和临床原发性肝癌（HCC）患者后,肿瘤微血管密度（MVD）、血管内皮生长因子（VEGF）及CT灌注参数（BF、BV、PS）的变化情况。方法 60例兔VX2肝癌模型均分为三组,单纯TACE治疗组、联合治疗组（TACE联合Endostar）、对照组。40例经病理证实的HCC患者均分为两组,单纯TACE治疗组和联合治疗组（TACE联合Endostar）。分析各组实验动物或病例在治疗前后病理免疫组化（VEGF、MVD）和CT灌注扫描（BF、BV、PS）的改变。结果治疗前,三组兔VX2肝癌模型、两组HCC患者在BF、BV、PS和VEGF、MVD方面差异均无统计学意义。治疗后,联合治疗组（兔VX2肝癌模型、HCC患者）的VEGF、MVD均较单纯TACE组降低,BF、BV、PS均较单纯TACE组升高,差异均存在统计学意义。结论 TACE联合Endostar可以有效抑制兔VX2肝癌模型和临床HCCTACE术后的新生血管的形成,降低肿瘤复发或转移的几率,提高治疗效果。

The Experimental and Clinical Application Research of TACE Combined with Endostar Therapy in Liver Cancer

Objective To investigate the MVD,VEGF and CT perfusion features（BF,BV,PS） of live cancer after TACE combined with endostar in rabbits VX2 hepatic tumor models and clinical HCC patients.Methods 60 rabbits VX2 hepatic tumor models were randomly and equally divided into three groups： group of TACE,group of combination （TACE＋Endostar）,control group.40 patients of HCC proved by pathology were equally divided into two groups： group of TACE,group of combination （TACE ＋Endostar）.CT perfusion imaging and immunohistochemical method were performed on all rabbit and patient before or after therapy.The CT perfusion features （BF,BV,PS）,VEGF and MVD were recorded.Results Before therapy,there were no significant difference in VEGF,MVD,BF,BV and PS among three groups of rabbits and between two groups of patient.After therapy,the value of VEGF,MVD of group of combination were noticeably lower than those in group of TACE in rabbits VX2 hepatic tumor models and clinical HCC patients,while the value of BF,BV and PS were noticeably higher than those in group of TACE in rabbits and patients.Conclusion The combination therapy of TACE and endostar via hepatic artery infusion can significantly slow down the growth speed and inhibit tumor angiogenesis and reduce the rate of relapse or metastasis of liver tumors.