肝细胞癌变过程中VEGF动态表达及其临床价值研究

目的观察肝细胞癌癌变过程中血管内皮生长因子（VEGF）动态表达及其在肝癌诊断中的临床意义。方法以2-乙酰氨基芴（2-FAA）喂饲雄性SD大鼠诱发肝细胞癌变，分别观察肝细胞形态学（HE染色）及血VEGF动态变化；按自身配对原则收集肝癌和远癌组织，以免疫组化法分析肝癌VEGF表达与病理学特征；以酶联免疫吸附法分析癌组织及良恶性肝病患者血中VEGF水平和临床价值。结果诱癌后肝细胞从发生颗粒样变性、不典型增生到肝癌形成过程中，VEGF表达呈梯度增加。肝组织中VEGF呈棕黄色或棕褐色，分布于癌细胞胞浆中，VEGF阳性率在肝癌组织为63．9％、无包膜组为78．3％、伴远处转移组为90．9％；癌组织VEGF比浓度（pg／mg肝）明显高于远癌组织（P〈0．01）。肝癌患者血VEGF水平明显高于慢性肝炎组、肝硬化组及正常对照组。结论肝细胞癌变过程中VEGF异常表达，对其分析有助于肝癌诊断及转移监测。

Dynamic expression and clinical values of vascular endothelial growth factor during development of hepatocellular carcinoma

Objective To investigate the dynamic expression of vascular endothelial growth factor （VEGF） and its clinical values for hepatocetlular carcinoma （HCC）. Methods Hepatoma models were made with 2-fluorenylacetamide （2-FAA） on male Sprague-Dawley rats. The changes of hepatocyte morphology （ H＆E staining） and VEGF expression at different stages of rat HCC formation were observed, respectively. HCC tissues and their matched distal cancerous tissues, and peripheral venous blood were collected in patients with liver diseases. Hepatic VEGF expression were investigated by immunohistochemistry. The VEGF levels were quantitatively detected by ELISA. Results The rat hepatocytes showed vacuole-like denaturation, hyperplastic nodal appearance and cancerous nest during development of HCC with an increasing tendency of VEGF expression. The positive expression showed palm- yellow or palm-brown granules in human HCC. The incidence of VEGF was 63. 9% in HCC,78. 3% in non- encapsulated HCCs, and 90.9% in HCCs with extrahepatic metastasis, respectively. The specific concentration （ pg/mg liver） of HCC VEGF was significantly higher （ P 〈 0. 01 ） than their distal cancerous tissues. Serum VEGF in HCC was significantly higher than that in chronic hepatitis or cirrhosis or controls. Conclusions Abnormal expression of VEGF during HCC development, and its analysis is a useful marker for diagnosis and monitoring metastasis of HCC.