肝细胞肝癌患者TACE前后血清sICAM-1的表达及其意义

目的探讨血清sICAM-1在原发性肝细胞癌（HCC）患者经肝动脉插管化疗栓塞（TACE）前后表达变化的临床意义。方法运用ELISA方法测定50例原发性HCC患者第1次TACE术前、术后3天、7天及1个月血清ICAM-1的水平及50名健康对照者的血清ICAM-1水平,将HCC患者术前与健康体检者、HCC患者TACE前后sICAM-1的表达水平进行比较。结果TACE术前原发性HCC患者sICAM-1的水平（651.08±65.29）μg/L]明显高于健康对照组sI-CAM-1的含量（197.29±38.87）μg/L,P〈0.01];原发性HCC患者术前门静脉癌栓组的sICAM-1水平明显高于无门静脉癌栓组（P〈0.01）,术前sICAM-1水平在甲胎蛋白（AFP）各不同含量组间无明显差异（P〉0.05）。术后3天sICAM-1水平（539.60±61.94）μg/L]与术后7天sICAM-1水平（496.22±58.78）μg/L]较术前有显著下降（P〈0.01）;术后1个月sICAM-1的水平（597.32±81.60）μg/L]与术前相比差异无统计学意义（P〉0.05）。结论sICAM-1水平的变化与肿瘤活性密切相关,可以作为评价HCC转移、复发及预后的指标,尤其对AFP阴性的HCC患者,在评价TACE疗效与判断再次TACE指征方面有一定参考价值。

Significance of the changes in serum soluble intercellular adhesion molecule-1 in patients with hepatocellular carcinoma before and after TACE

Objective To investigate the clinical significances of the changes in serum soluble intercellular adhesion molecule-1 （slCAM-1） in patients with hepatocellular carcinoma （HCC） before and after transcatheter hepatic arterial chemoembolization （TACE）. Methods The serum levels of sICAM-1 in 50 patients with HCC before the first TACE, on the 3rd day, 7th day and 1 month after TACE and that of 50 healthy participants were respectively detected by ELISA and compared. Results Compared with control group （197.29＋-38.87]μg/L）, the level of sICAM-1 in patients with HCC before the first TACE （651.08±65.29]μg/L） increased significantly （P〈0.01）. Among all HCC cases, the level of sICAM-1 before TACE in the patients with portal vein tumor thrombli was significantly higher than that in the group without portal vein thrombosis （P〈0.01）. There was no significant difference in patients with HCC among different AFP groups before the first TACE （P〉0.05）. The level of sICAM-1 declined significantly on the 3rd day and 7th day after TACE （539.60 ±61.94]μg/L, 496.22±58.78]tzg/L, respectively, P〈0. 01）. There was no remarkable changes for the level of sICAM-1 before and 1 month after TACE （597.32±81.60]fxg/L, P〉0.05） Conclusion slCAM-1 levels in patients with HCC were closely related to the activity of the tumor. It can be used for the evaluation of HCC metastasis, recurrence and prognosis. Especially for those AFP are negative, dynamic changes of serum sICAM-1 is helpful to estimating the prognosis after TACE and the indication of re-TACE treatment.