引用本文:宋 磊,吕 申.原发性肝癌TACE治疗前后血浆VEGF水平变化及其与疗效间相关性的研究[J].大连医科大学学报,2008,30(3):232-235+239.
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原发性肝癌TACE治疗前后血浆VEGF水平变化及其与疗效间相关性的研究
宋 磊1, 吕 申2
1.大连医科大学 附属第二医院 肿瘤内科;2.大连医科大学 附属第二医院 中心实验室,辽宁 大连 116027
摘要:
[目的]探讨血浆中血管内皮生长因子作为肝癌介入治疗(TACE)疗效判定指标的可行性,同时了解血浆VEGF水平与肝癌生物学特性的关系。[方法]13例原发性肝癌患者,行TACE治疗。术前1天、术后第1、3、7、14、28天留取血样标本,分离血浆,酶联免疫吸附实验(ELISA)的方法检测血浆VEGF水平;分析血浆VEGF水平与肝生化、甲胎蛋白及影像学特征间的关系。[结果]血浆VEGF水平在TACE治疗前1天、治疗后第1、3、7、14、28天的均值分别为:284.97±73.60、534.38±130.17、398.13±92.42、363.33±64.42、434.68±77.67、374.77±140.46,术后第1天明显升高,与术前相比差异有显著性意义(P<0.05),术后第3天、7天较第1天明显下降,至术后第14天略有升高。血浆中VEGF在合并门脉癌栓、动门脉瘘及远处转移患者中呈较高水平;与病灶位置、肿瘤染色情况、肿瘤有无包膜无明显相关关系(P>0.05);与AFP、GPT、AST、TB、ALB、PLT,无明显相关性(P>0.05)。13例TACE治疗患者疗效较好组8例,疗效较差组5例,两组间血浆VEGF水平术前及术后第28天比较差异具有统计学意义 (P<0.05),TACE治疗前后血浆VEGF变化率(术后第28天/术前×100%)与术后病灶区碘油存积情况有明显相关性(r=-0.644,P=0.017)。 [结论]血浆VEGF是一项独立于AFP的,早期、敏感、有效的介入治疗疗效评价指标。
关键词:  原发性肝细胞癌  血管内皮生长因子  肝动脉灌注化疗并栓塞  酶联免疫吸附测定
DOI:10.11724/jdmu.2008.03.11
分类号:R73
基金项目:
Possibility of VEGF as a marker to evaluate effectiveness of intervention therapy to hepatorcellular carcinoma
SONG Lei1, Lü Shen2
1.Department of Oncology,;2.Medical Center, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China
Abstract:
[Objective]To explore the feasibility of VEGF as a marker to evaluate the effectiveness of transarterial chemoembolization (TACE) of HCC (hepatic cell cancer), and to study the correlation between the level of plasma VEGF level and biological characteristics of HCC.[Methods]Peripheral bloods were sampled at the 1st day before the therapy and at the 1st, 3rd, 7th, 14th, and the 28th day after intervention therapy, respectively, from 13 patients with HCC receiving with TACE treatment. The quantitative sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma VEGF level. Analysis on the relationship between plasma VEGF levels and hepatic biochemistry level, level of AFP, and index or the imageological features of HCC.[Results]The mean of Plasma VEGF levels at the 1st day before the TACE, at the 1st, 3rd, 7th, 14th, and the 28th day after the treatment were 284.97±73.60, 534.38±130.17, 398.13±92.42, 363.33±64.42, 434.68±77.67 and 374.77±140.46 respectively; VEGF level at the 1st day after the treatment was significantly higher than that before the treatment (P<0.05), then it was decreasing gradually as observed on the 3rd and 7th day, and then increased slightly on the 14th day. Higher level of plasma VEGF was observed in patients complicated with tumor embolism in portal vein or with fistula between hepatic artery and portal vein, or patients with remote metastases, but without significant correlation to the site and staining of the tumor, or the presence or not of the coating membrane of the tumor (P>0.05), without significant correlation to levels of AFP, GPT, AST, TB, ALB AND PLT (P>0.05). Good therapeutic effects were observed in 8 out of 13 patients, with the other 5 patients with poor response, and significant difference existed between the two groups of patients concerning levels of plasma VEGF before treatment and on the 28th day after treatment (P<0.05). Significant correlation existed between variation ratio of VEGR before and after treatment (calculated based on the formula of the 28th day/pretreatment×100%) and the deposit of iodized oil in the tumor (r=-0.644,P=0.017).[Conclusions]The level of plasma VEGF can be adopted as an early-stage, sensitive, efficient and AFP-independent marker on evaluation of therapeutic effect of intervention.
Key words:  HCC  VEGF  TACE  ELISA