摘要
目的探讨肝癌肝动脉灌注化疗栓塞术(transarterial chemoembolization,TACE)治疗后血清中缺氧诱导因子(HIF)-1a、血管内皮生长因子(VEGF)的含量变化对预后的影响。方法 2007年1月—2012年1月对60例肝癌患者行TACE治疗,另选20名正常人作为对照组,检测患者术前、术后血清HIF-1a VEGF含量。采用Cox回归模型分析KPS评分、Child-Pugh分级、门脉癌栓、血管侵犯及BCLC分期等因素对生存期的影响。采用Kanplan-Meier法分析术后血清中HIF-1a VEGF含量变化对预后的影响。结果 60例患者TACE术前HIF-1a和VEGF含量分别为(175.7±62.2)pg/ml和(346.6±134.6)pg/ml,明显高于对照组的(15.1±5.07)pg/ml和(49.9±11.2)pg/ml,差异有统计学意义(P<0.001)。术后第1天血清HIF-1a含量明显高于术前[(603.1±166.6)pg/ml比(175.7±62.2)pg/ml,P<0.01]。VEGF含量与术前相比差异无统计学意义(P>0.05)。术后1周血清HIF-1a、VEGF含量分别为(210.7±61.5)pg/ml和(300.1±82.6)pg/ml,较术前明显下降(P<0.05);术后1个月下降更明显[分别为(146.8±50.6)pg/ml和(244.8±54.5)pg/ml,P<0.001)]。Cox回归分析证实KPS评分、Child-Pugh分级、门脉癌栓、肝内外转移、血管侵犯等因素中,回归系数对风险度有重要相关性。Kanplan-Meier分析显示,术后血清HIF-1a、VEGF含量高低对评估预后有指导意义。结论肝癌患者行TACE治疗后血清HIF-1a和VEGF含量变化对预后有较大的影响。
[Abstract] Objective To investigate the influence of serum hypoxia-inducible factor lalpha （HIF-la） and vascular endothelial growth factor （VEGF） expression levels on the prognosis in patients with hepatocellular carcinoma （HCC） after transarterial chemoembolization （TACE）. Methods During the period from Jan. 2007 to Jan. 2012, TACE was carried out in 60 patients with HCC （study group）, and twenty healthy volunteers were involved in this study as control group. Using enzyme- linked immunosorbent assay （ELISA）, the serum HIF-la and VEGF levels were determined in patients both before and after TACE. By using Cox regression analysis, the KPS score, Child- Pugh classification, the portal vein tumor thrombus, vascular invasion and BCLC staging, these possible factors influencing the survival time, were analyzed. The influence of serum HIF-la and VEGF levels on the prognosis was analyzed by using Kanplan-Meier method. Results Before TACE, the serum HIF-la and VEGF contents in the study group were （175.7 ± 62.2） pg/ml and （346.6± 134.6） pg/ml respectively, which were significantly higher than those in the control group, which were （15.1 ± 5.07） pg/ml and （49.9 ± 11.2） pg/ml respectively. The difference was statistically significant （P 〈 0.001 ）. One day after TACE, the serum HIF-la content was （603.1 ± 166.6） pg/ml, which was distinctly higher than preoperative （175.7 _＋ 62.2） pg/ml. The difference was statistically significant （P 〈 0.01）. No significant difference in VEGF content existed between preoperative value and postoperative one （P 〉 0.05）. One week after TACE, the HIF-la and VEGF levels significantly decreased to （210.7 ＋ 61.5） pg/ml and （300.1 ~ 82.6） pg/ml respectively （P 〈 0.05）. At one month after TACE, the HIF-la and VEGF levels dropped more dramatically to （146.8 _＋ 50.6） pg/ml and （244.8 ＋ 54.5） pg/ml respectively （P 〈 0.001）. Cox regression analysis indicated that KPS score, Child- Pugh classification, the presence of portal vein tumor thrombus, hepatic and extra-hepatic metastases and vascular invasion were the important factors influencing the survival time. Kanplan- Meier analysis showed that postoperative serum HIF- la and VEGF levels had guiding significance in evaluating prognosis. Conclusion The changes of serum HIF-la and VEGF levels after TACE in patients with HCC will greatly influence the prognosis.（J Intervent Radial, 2014, 23： 142-146）
出处
《介入放射学杂志》
CSCD
北大核心
2014年第2期142-146,共5页
Journal of Interventional Radiology
关键词
肝癌
肝动脉灌注化疗栓塞术
血管内皮生长因子
缺氧诱导因子-1a
hepatocellular carcinoma
transarterial chemoembolization
vascular endothelial growth factor
hypoxia - inducible factor -1 a
