肝癌患者血清及肿瘤组织VEGF的表达及意义

The expression and value of VEGF in serum and tumor tissue in HCC patients

目的探讨肝癌患者血清及组织中VEGF的表达情况及其在预测肝癌侵袭和患者预后的意义。方法将64例手术切除肝细胞肝癌患者分为复发组(n=42)与未复发组(n=22),采用酶联免疫吸附和免疫组化方法检测患者的术前血清及标本中VEGF的表达情况,分析其与临床病理指标关系并进行复发风险多因素分析。结果血清VEGF的浓度为334.50±247.62pg/ml,明显高于健康对照组(P<0.01)。复发组血清VEGF浓度明显高于未复发组(P<0.05)。已复发组VEGF的阳性率为85.7%,未复发组为54.5%(P<0.05)。VEGF阴性组的1、2、3年无瘤生存率分别为81.3%、68.8%及62.5%,VEGF阳性组的分别为52.1%、33.3%及29.1%(P<0.01)。多因素分析表明术前播散结节、微转移灶及VEGF的表达水平是影响预后的危险因素。结论肝癌患者血清及肿瘤组织中VEGF的表达水平明显升高,与肝癌患者的术后复发相关,可预测患者的复发风险。

Objective To investigate the expression and clinical value of VEGF in estimating the invasion and prognosis of HCC. Methods The expression of VEGF in 64 serum and resection specimens of HCC, confirmed by pathology, was detected by enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry. Correlations of the expression of VEGF to clinicopathologic features were analyzed. Cox regression model was used to analyze the recurrence and VEGF after hepatectomy. Results The serum level of VEGF in HCC patients was 334.50±247.62 pg/ml, and significantly higher than healthy control group (P<0.01). The serum level of VEGF was significantly higher in recurrent group than in non-recurrent group (P< 0.05). The positive rate of VEGF was significantly higher in recurrent group than in non-recurrent group(85.0% vs 54.5%, P< 0.05), and was positively correlated to recurrence of HCC (P<0.01). The 1-, 2-, and 3-year tumor-freely survival rates were significantly higher in VEGF(-) group than in VEGF(+) group (81.3% vs 52.2%, 68.8% vs 33.3%, and 62.5% vs 29.1%, P< 0.01). Multivariate analysis revealed that preoperative disseminated nodes, tumor micrometastasis, and the expression of VEGF were independent recurrence risk factors. Conclusion The expression of VEGF in serum and specimens of HCC patients ascends distinctly, which correlates to the recurrence of HCC after hepatectomy. The expression of VEGF can be used to estimate the risk of relapse.