TACE联合血管内皮抑制素治疗肝癌的短期疗效及其对患者血清VEGF、MMP-9、OPN的影响

目的:探讨经肝动脉化疗栓塞（TACE）联合血管内皮抑制素治疗肝癌的短期疗效及其对患者血清VEGF、MMP-9、OPN的影响。方法:选取2012年4月-2013年4月我院收治的原发性肝细胞癌（简称肝癌）患者80例，按照随机对照法分为观察组和对照组各40例，其中观察组给予TACE联合重组人血管内皮抑制素（恩度）治疗，对照组采用单纯的TACE治疗，观察两组患者治疗前、治疗后1、3、7、15、30d血清血管内皮生长因子（VEGF）、基质金属蛋白酶9（MMP-9）、骨桥蛋白（OPN）水平的变化，观察两组患者肿瘤新生血管抑制情况、肿瘤控制情况及1年生存率。结果:治疗前两组的血清VEGF、MMP-9、OPN水平比较差异无统计学意义（P＞0.05）；治疗后各时间节点观察组血清VEGF、MMP-9、OPN水平与治疗前比较差异无统计学意义（P＞0.05）；而对照组治疗后各时间节点血清VEGF、MMP-9、OPN水平均较治疗前明显升高，差异具有统计学意义（P＜0.05）；观察组患者新生血管控制率、疾病控制率（DCR）及术后1年生存率均明显优于对照组，差异具有统计学意义（P＜0.05）。两组的不良反应发生率比较差异无统计学意义（P＞0.05）。结论:TACE联合血管内皮抑制素治疗肝癌可以有效抑制肿瘤新生血管的形成，降低肿瘤复发转移的几率，延长患者的生存时间，提高生存率，其作用机制可能与抑制TACE术后血浆VEGF、MMP-9、OPN水平有关。

The short-term curative effect and the serum levels of VEGF,MMP-9, OPN of the liver cancer patients treated by transcatheter arterial chemoembolization combined with endostatin

Objective:To study the short-term curative effect and the serum levels of VEGF,MMP-9,OPN of the liver cancer patients treated by the transcatheter arterial chemoembolization combined with endostatin.Methods:Selected 80 patients with primary hepatocellular carcinoma (HCC),divided into observation group and control group(n=40).The observation group was given TACE combined endostatin treatment,the control group given TACE treatment.Observe the level of serum vascular endothelial growth factor (VEGF),matrix metalloproteinase 9 (MMP-9),osteopontin (OPN) before and 1,3,7,15,30d after treatment,and inhibition situation of angiogenesis of tumor,tumor control rate and 1 year survival rate.Results:The serum VEGF,MMP-9,OPN levels of two groups before treatment had no statistical significance differences (P＞0.05).The serum levels of VEGF,MMP-9,OPN of the observation group each time node after treatment had no statistically significant difference compared with before treatment (P＞0.05).While the serum levels of VEGF,MMP-9,OPN of the control group at each time point after treatment had statistically significant difference compared with before treatment (P＜0.05).The angiogenesis of tumor inhibition rate,disease control rates (DCR) and postoperative 1 year survival rate of the observation group were significantly better than the control group,the difference had statistical significance (P＜0.05).The incidence of adverse reactions of the two groups had no statistical significant(P＞0.05).Conclusion:TACE combined with endostatin in treatment of liver cancer can effectively inhibit the formation of new blood vessels of tumor,reduce the risk of tumor recurrence,metastasis,prolong survival time,improve the survival rate.Its mechanism may be related to the inhibition of the serum VEGF,MMP-9,OPN levels.