恩度联合TACE术治疗肝癌对患者血清VEGF、HIF-1A、OPN、MMP-9的影响及意义

目的 观察并探讨恩度联合肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)对肝癌(hepatocellular carcinoma,HCC)患者血清血管内皮生长因子(VEGF)、低氧诱导因子-1(HIF-1A)、骨桥蛋白(OPN)、基质金属蛋白酶(MMP-9)水平的影响。 方法 选择自2011年7月—2014年11月医院治疗的HCC患者80例，按照随机数字法分为2组，观察组和对照组各40例。对照组患者给予TACE治疗，观察组则在对照组基础上联合恩度治疗。治疗前及治疗后4周测定2组患者VEGF、HIF-1A、OPN和MMP-9水平变化，并在治疗结束后评价2组综合疗效及不良反应。 结果 术前2组VEGF、HIF-1A、OPN和MMP-9水平相比，差异不具有统计学意义(P＞0.05)，治疗后，观察组VEGF、HIF-1A、OPN和MMP-9水平分别为(431.2±132.2)pg/ml、(58.4±0.7)ng/L、(76.4±18.2)μg/L和(194.3±82.2)ng/ml，对照组为(562.8±184.4)pg/ml、(62.4±1.1)ng/L、(88.3±19.2) μg/L和(238.4±94.4)ng/ml，观察组VEGF、HIF-1A、OPN和MMP-9水平均明显低于对照组(P＜0.05)；观察组有效率为95.0%(38/40)，对照组为77.5%(31/40)，观察组有效率明显高于对照组(P＜0.05)；2组不良反应发生率相比，差异不具有统计学意义(P＞0.05)。 结论 恩度联合TACE术治疗HCC能通过降低VEGF、HIF-1A、OPN和MMP-9水平来达到控制肿瘤进展的效果。 

Influence and significance of hepatic transcatheter arterial chemoembolization combime with endostar on levels of serum VEGF,HIF-1A,OPN and MMP-9 in patients with hepatocellular carcinoma

Objective To observe and explore the influence and significance of Hepatic Transcatheter Arterial Chemoembolization(TACE) combine with Endostar on serum VEGF,hypoxia inducible factor(HIF)-1,osteopontin(OPN),matrix metalloproteinase 9(MMP-9) in patients with Hepatocellular carcinoma(HCC). Methods Total 80 cases of HCC between July 2011 and November 2014 in our hospital were selected and divided into two groups according to the random number method.The control group received TACE treatment,while the observation group receiged the combined therpaudy with endostar and TACE.HIF-1A,OPN,VEGF and MMP-9 levels were measured before the treatment and 4 weeks after the treatment,the efficacy in both groups were evaluated after the treatment,and adverse reactions were recorded and compared. Results The difference of VEGF,HIF-1A,OPN and MMP-9 levels before the treatment was not statistically significant(P>0.05),after the treatment,VEGF,HIF-1A,OPN and MMP-9 levels in the observation group were(431.2±132.2)pg/ml,(58.4±0.7)ng/L,(76.4±18.2)μg/L and(194.3±82.2)ng/ml,respectively,while was(562.8±184.4)pg/ml,(62.4±1.1)ng/L,(88.3±19.2)μg/L and(238.4±94.4)ng/ml,respectively,in the control group,VEGF,HIF-1A,OPN and MMP-9 levels in the observation group were significantly lower than those in the control group(P<0.05);The efficacy in observation group was 95.0%(38/40),while was 77.5%(31/40)in the control group,the observation group was significantly higher(P<0.05);the difference of adverse reactions incidence was not statistically significant(P>0.05). Conclusion Endostar combined with TACE in the treatment of HCC can reduce VEGF,HIF-1A,OPN and MMP-9 levels,and limit tumor progression effect.