清肝化瘀口服液对肝细胞癌介入治疗后血管内皮生长因子及环氧合酶2表达的影响

目的 探讨中药清肝化瘀口服液在肝细胞癌患者肝动脉化疗栓塞(TACE)术后辅助治疗对抑制癌细胞增殖、降低环氧合酶2(COX-2)和血管内皮生长因子(VEGF)表达的作用,为中药的临床研究提供试验依据.方法 随机选取2006年2月至2007年2月住院的原发性肝细胞癌患者60例,分为观察组30例TACE术后给予中药清肝化瘀口服液治疗,对照组30例单纯TACE治疗.采用双抗体夹心酶联免疫吸附测定(ELISA)法检测患者治疗前后血清中VEGF水平的表达;采用反转录聚合酶链反应(RT-PCR)检测COX-2基因水平表达;CT和(或)超声及胸片检查,随访观察肺、骨、脑及淋巴结的转移情况.结果 观察组治疗后外周血中VEGF表达明显低于治疗前和对照组治疗后VEGF表达,(207.5±93.2)μg/L vs(295.2±106.5)μg/L、(456.1±175.5)μg/L(P<0.05或<0.01).观察组治疗后外周血有核细胞中COX-2阳性表达率较治疗前和对照组治疗后COX-2阳性表达率呈下降趋势.观察组肝外转移发生率为20.0%,明显低于对照组肝外转移发生率的46.7%.结论 观察组外周血中VEGF及COX-2表达降低,肝外转移发生率亦降低,说明TACE联合应用清肝化瘀口服液在控制肿瘤转移中具有重要意义.

Effects of Qing Gan Hua Yu orally liquid on tumor metastasis in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization

Objective In this study,the traditional Chinese medicine was given to the hepatocellular carcinoma（HCC） patients after transcatheter arterial chemoembolization（TACE）.The contents of vascular endothelial growth factor（VEGF） and cyclooxygenase-2（COX-2） in peripheral blood were also examined and the composite index of the patients was observed.This study revealed the effects of Qing Gan Hua Yu orally liquid on the suppression of the proliferation of hepatoma cells and the decreasing of the expression of VEGF and COX-2.This study illuminated the contribution of Qing Gan Hua Yu orally liquid to the therapy of HCC from HCC metastasis sides.Methods Random selection from the Fourth Hospital of Hebei Medical University Feb 2006 to Feb 2007 HCC patients hospitalized included 60 cases,30 patients treated with Qing Gan Hua Yu were divided into observation-group,and other 30 cases treated with TACE into control-group.We detected VEGF by enzyme immunosorbent assay（ELISA） and COX-2 by real-time polymerase chain reaction（RT-PCR）.Also we rechecked computed tomography（CT）,ultrasound or sternite,and conducted follow-up visits for the aversion from liver to lung,bone,brain and absorbent gland.Results In observation-group of VEGF expression of peripheral blood was decreased in comparison with between innergroup′s and pre-treatment,and with post-treatment of control group,（207.5±93.2） μg/L vs（295.2±106.5） μg/L,（456.1±175.5） μg/L（P〈0.05 or 0.01）.COX-2-positive expression in peripheral blood lymphocyte in observation group between post-and pre-treatment as well as with control group in post treatment showed a decrease trend.In observation-group,the metastasis rate was 20.0%.In control-group,the metastasis rate was 46.7%.The difference between two groups had statistical significance（P〈0.05）.Conclusion The expression of VEGF and COX-2 in peripheral blood degraded significantly in the TACE with Qing Gan Hua Yu orally liquid therapy group.Using Qing Gan Hua Yu orally liquid after TACE therapy can inhibit the metastasis in tumor.