肝癌化疗栓塞术后残癌组织微血管密度及血管内皮细胞生长因子表达的研究

目的 研究肝癌经导管动脉内化疗栓塞(transcatheter arterial chemoembolization,TACE)术后残癌组织微血管密度(microvessel density,MVD)、血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)和成纤维细胞生长因子(basic fibroblast growth factor,BFGF)的表达变化。方法 对40例原发性肝癌患者的手术切除标本作免疫组织化学染色,检测肿瘤组织的MVD和肿瘤细胞VEGF、BFGF的表达。40例患者中20例术前接受l~7次不等的TACE治疗(TACE组),另20例为直接手术患者,术前未进行任何其它治疗(直接手术组)。结果TACE组平均MVD为130.51±75.5,直接手术组为152.35±58.80,两组差异无显著性(t=－1.021．P=0.341)。VEGF平均染色强度TACE组为645.60±543.27,直接手术组为158.28±188.48,前者强于后者(t=281,P＜0.001)。BFGF阳性率TACE组和直接手术组分别为35%和40%,差别无显著性(x~2=0.107,P=0.744)。结论TACE术后残癌组织只有丰富的肿瘤血供,残存肿瘤细胞VEGF表达增强,可能在TACE术后肿瘤血供的重建中起重要作用。

Intratumoral microvessel density and expression of vascular endothelial growth factor in hepatocellular carcinoma after chemoembolization

OBJECTIVE: To investigate intratumoral microvessel density (MVD) and expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (BFGF) in hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) and to evaluate their significance. METHODS: MVD and expression of VEGF and BFGF in cancerous tissues were examined in forty specimens resected from patients with HCC using immunohistochemical methods. Among these patients, 20 patients received 1 to 7 treatments of TACE prior to II-phase surgical resection (TACE group), the other 20 patients were treated by operation without receiving any other treatment preoperatively (surgical group). There was no significant difference in clinical features between the two groups. MVD was assessed by counting immunostained endothelial cells within a certain area, and staining intensity of VEGF was assessed quantitatively with computer-assisted image analyzer. The expression of BFGF was determined by cell-positive or cell-negative. RESULTS: The average MVD was 130.51 75.5 in TACE group and 152.35 58.80 in surgical group. There was no significant difference between the two groups (t=-1.021, P=0.341). Staining intensity of VEGF was 645.60 543.27 in TACE group, higher than in surgical group (158.28 188.48, t=281, P<0.001). BFGF-positive rate was 35% in TACE group and 40% in surgical group. There was no significant difference (x(2)=0.107, P=0.744). CONCLUSIONS: The results indicate that survived cancerous tissue has rich vascularity and the expression of VEGF of the cancerous cells can be enhanced by TACE which may play an important role in reestablishment of blood supply to tumor after TACE.