卡培他滨抑制肝细胞癌肺转移的临床观察

目的探讨卡培他滨对肝细胞癌(HCC)肺转移的抑制作用。方法用免疫组织化学法检测10例HCC及其肺转移灶组织中血小板衍化内皮细胞生长因子(PD-ECGF)的表达；3例肝癌切除术后复查发现肝癌肺转移的病人采用PD-ECGF相关的卡培他滨化疗(剂量为1250mg／m^2，2次/d，口服持续14d，再停止7d，21d为一个化疗周期)；每例病人5～6个周期。结果10例HCC组织中有7例表达PD-ECGF，癌周正常肝组织中表达率仅30％(3／10)，而其肺转移灶组织中有8例表达。3例病人均能耐受卡培他滨治疗，未见严重的化疗并发症。1例口服卡培他滨疗程结束后复查发现肿瘤完全缓解，肺转移灶消失；1例肺转移灶稳定无进展；1例肺转移灶进展并转移至脑部。3例病人发现肝癌肺转移后生存分别已达18、13和5个月。结论PD-ECGF在HCC肺转移灶组织中高表达，卡培他滨口服化疗可作为治疗肝癌肺转移的有效治疗措施之一。

A clinical study on inhibition of lung metastasis of hepatocellular carcinoma by capecitabine

Objective To study the inhibitory effects of capecitabine, a new tumor-selective chemotherapeutic agent, on lung metastasis of hepatocellular carcinoma (HCC). Methods Expression of platelet-derived endothelial cell growth factor (PD-ECGF) in 10 HCC tissues and 10 lung metastatic tissues of HCC were determined with immunohistochemistry. Three cases of lung metastasis of HCC were treated with intermittent oral administration of capecitabine at a dose of (1 255) mg/M~2 twice daily (two-week treatment followed by a one-week rest period as one cycle) after liver cancer removal. Each patient received 5-6 cycles of treatment with capecitabine. Results The rate of expression of PD-ECGF in HCC and its lung metastatic tissues was 70% and 80%, respectively, whereas that in the nontumoral liver tissue was only 30%. All the 3 patients could tolerate the treatment with capecitabine. Complete response of lung metastasis was observed in 1 patient, lung metastasis was stable in 1 and brain metastasis was found in the third one. The survival time in the 3 patients after lung metastasis was 18, 13 and 5 months, respectively. Conclusions PD-ECGF is highly expressed in lung metastatic tissue of HCC. Oral administration of capecitabine may be one of the effective measures to inhibit the lung metastasis of HCC.