原发性肝癌患者血清中血管内皮生长因子检出的临床意义

Clinical significance of vascular endothelial growth factor of serum in patients with primary hepatic carcinoma

关键词:  血管内皮生长因子  原发性肝癌  血清

Key words:  VEGF  PHC  Serum

摘要:

分析血管内皮生长因子（VEGF）在原发性肝癌血清中的表达及其意义。 ［方法］ 对124例临床确诊的肝癌病人进行肝动脉化疗栓塞术或肝动脉栓塞术。分别检测术前、 术后血清VEGF和甲胎蛋白（AFP）的水平、肿瘤大小、肿瘤中碘化油填充量及其形态分布， 分别进行比较、分析。 ［结果］全部病例术前、术后平均VEGF水平分别为510.63±45.26、 327.84±20.49，具有显著性差异(P<0.05)。血清VEGF下降程度与肿瘤缩小程度，碘化 油充填量Ⅰ、Ⅱ、Ⅲ型呈正相关性，与Ⅳ型关系不大；VEGF对肝癌近期治疗疗效具有良好的 敏感性，尤其是在AFP阴性或AFP<20 μg/L病例中其意义尤为显著；在小肝癌患者中， 治疗疗效分别 为：CR+PR：23.81%；SD：50.00%；PD：26.19%，各组平均血清VEGF水平在术前、术后 具有 显著性差异(P<0.05)，提示VEGF能够更好、更直观地反映肿瘤血管的破坏程度和治疗疗效。［结论］VEGF与肝癌的进展、转移、预后相关性极强，作为肿瘤血管的标志具有较好的指示作用。

Abstract:

To evaluate the significance of vascular endothe lial growth factor(VEGF) of serum in patients with primary hepatic carcinoma. ［Methods］ Transcatheter arterial chemotherapy embolization (TACE) was applied to 124 patients with primary hepatic carcinoma(PHC).The expression of VEGF before and after TA CE was determined by biochemical colorimetric method, and the relations among VE GF, A-Fetoprotein(AFP),tumor size, type of lipiodol-ultrafluid sufficiency and c urative effect was studied. ［Results］ The differences in serum VEGF between b ef ore and after treatment in all cases achieved statistical significance (510.63± 45.26 v 327.84±20.49).The serum VEGF level dropped markedly with the reduction of the tumor size, type Ⅰ、Ⅱ、Ⅲ of lipiodol-ultrafluid sufficiency ；VEGF can suggest tumor vascular endothelial growth among the patients whose serum AFP le vels were lower than 20 ng/mL; CR+PR：23.81%；SD：50.00%；PD：26.19% in patients with small PHC，and serum VEGF between before and after treatment was significan tly different. VEGF was remarkable and effective index with the tumor vascular g r owth of patients with PHC, and the change of the factor was accordant with the s i ze reduction of tumor. ［Conclusions］ Expression of VEGF can be used as an earl y diagnosis of patients with PHC with AFP and image examination. It has an importa nt significance in evaluating tumor size, curative effect and prognosis.