VEGF在术前接受过肝动脉栓塞化疗的肝癌组织中的表达及临床意义

目的探讨血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)在接受术前经导管肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)肝癌细胞中的表达和在二期切除肝癌复发预后中的意义。方法选取91例术前TACE和50例未行TACE肝癌手术切除标本,采用免疫组化方法检测两组标本VEGF的表达情况。分析两组VEGF的表达的差异及术前TACE后根治性切除的肝癌中VEGF的表达水平与复发的关系。结果 VEGF表达于肝细胞浆中,术前TACE组和未行TACE组VEGF的表达(6.9±4.7VS5.1±4.4)有显著性差异(P<0.05)。术前TACE后根治性二期切除患者,复发组与未复发组肿瘤组织中VEGF阳性率分别为82.2%和41.2%,差异有统计学意义(P<0.05)。VEGF表达阳性组1、3、5年无瘤生存率分别为50.9%、28.1%、22.5%,VEGF阴性组分别为88.5%、68.2%、53.0%,差异有统计学意义(P<0.05)。多因素分析表明治疗前存在播散结节及VEGF的表达水平是影响TACE后二期切除患者复发的独立危险因素。结论 VEGF在TACE残癌组织中表达增强,VEGF的表达与TACE后根治性切除肝癌患者术后的复发转移有关。

Expression and Significance of VEGF in Hepatocellular Carcinoma Patients Receiving Preoperative Transcatheter Arterial Embolization

Objective To study the expression and significance of vascular endothelial growth factor (VEGF) in hepatocellular carci-noma (HCC) patients who underwent preoperative preoperative transcatheter arterial embolization (TACE). Methods The expression of VEGF in 91 specimens of HCC with preoperative TACE (TACE group) and 50 specimens of HCC (non-TACE group) were detected by immunohistochemistry. The expressions of VEGF between the two groups were compared. Correlations of VEGF expression to the recurrence were analyzed. Results VEGF was expressed in cytolymph.The expression of VEGF was significantly higher in TACE group than non-TACE group,respectively (6.9 ± 4.7 vs 5.1 ± 4.4,P <0.05). In patients who underwent curative resection after preoperative TACE,the positive rates of VEGF were significantly higher in recurrent group than in non-recurrent group (82.2% vs 41.2%,P < 0.05). The 1-,3-,and 5-year disease-free survival rates were significantly higher in VEGF-negative group than in VEGF-positive group (88.5% vs 50.9%,68.2% vs 28.1%,and 53.0% vs 22.5%,P <0.05). Multivariate analysis revealed that preoperative disseminated nodes and the expression of VEGF were independent recurrence risk factors. Conclusion The Expression of VEGF remarkably increased in TACE group. The expression of VEGF was correlated to postoperative recurrence of HCC patients who underwent preoperative TACE.