原发性肝癌患者肝动脉化疗栓塞前后血管内皮生长因子表达水平的研究

目的分析血管内皮生长因子（VEGF）在原发性肝癌（PHC）患者肝动脉化疗栓塞（TACE）前后血清中的表达水平及其意义。方法采用酶联免疫吸附（ELISA）法检测20例健康人血清中的VEGF表达水平和对32例临床确诊的原发性肝癌病人进行肝动脉化疗栓塞术,分别检测术前1天、术后28天血清VEGF和甲胎蛋白（AFP）的表达水平并分别进行比较、分析。结果 32例PHC患者血清中VEGF表达水平（225.13±120.24）ng/L明显高于健康人群（27.28±22.86）ng/L（P〈0.01）,具有显著性差异,全部病例术前1天、术后28天血清中VEGF平均表达水平分别为（225.13±120.24）ng/L、（160.52±80.57）ng/L（P〈0.05）,具有显著性差异,证实VEGF在肝癌的生长转移和发展中起重要的作用,TACE治疗前后血清VEGF下降变化与术后病灶区碘油沉积情况和/或伴有门静脉癌栓有明显相关性,对肝癌近期治疗疗效具有良好的敏感性,尤其是在AFP阴性病例中其意义尤为显著;能够更直观地反映肿瘤血管的破坏程度和治疗疗效。结论血清VEGF是一项独立于AFP的、能够更好地做为原发性肝癌介入疗效评价标准的指标,能够反映肝癌的进展、转移及预后。

Expression levels of vascular endothelial growth factor in patients with primary liver cancer before and after TACE

Objective To analyze the expression levels of vascular endothelial growth factor（VEGF） in primary liver cancer（PHC） before and after transarterial chemoembolization（TACE） in serum and its significance.Methods：Serum levels of VEGF expression were detected with enzyme-linked immunosorbent assay（ELISA） in 20 cases of healthy people and 32 cases of primary liver cancer patients.The serum VEGF and alpha-fetoprotein（AFP） expression were compared and analyzed 1 day before and 28 days after TACE.Results：Serum levels of VEGF expression in 32 patients with PHC（225.13 ± 120.24） ng /L was significantly higher than that in healthy people（27.28 ± 22.86） ng /L（P0.01） with significant differences.The average expression level of VEGF in serum of all patients 1 day before and 28 days after TACE were（225.13 ± 120.24） ng /L,（160.52 ± 80.57） ng /L（P0.05）,with significant differences,which confirmed the VEGF played an important role in HCC metastasis and development.Changes in serum levels of VEGF after TACE associated with lipiodol deposition and /or portal vein tumor thrombus,which had good sensitivity to evaluate the short-term efficacy,especially in the AFP-negative cases;which could directly reflect the extent of the damage of tumor blood vessels and treatment efficacy.Conclusion：Serum VEGF is an indicator to evaluate the efficacy of TACE independent on AFP,and it may reflect the progress,metastasis and prognosis of liver cancer.