免疫化疗栓塞技术对原发性肝癌患者术后VEGF的影响

Significance of preventive transcatheter arterial immune n in VEGF in primary liver cancer after operation

目的探讨免疫化疗栓塞术对肝癌术后患者外周血血管内皮生长因子（VEGF）的影响。方法选择146例可手术的原发性肝癌患者，随机分为A组、B组和C组。A组单纯手术，B组术后肝动脉化疗栓塞术（TACE），C组术后行免疫化疗栓塞术。A组常规方法行肝癌切除术，术后予以对症支持治疗；B组术后1个月行TACE，方案为阿霉素＋顺铂＋5一氟尿嘧啶＋碘化油；C组方案改为阿霉素＋顺铂＋5一氟尿嘧啶＋碘化油＋奥曲肽＋干扰素，余同B组。酶联免疫吸附测定法测定所有患者术前、术后1天、术后1个月，介入治疗术后第1、3、7、14天及1个月的VEGF值。结果原发性肝癌患者术前VEGF较高，而术后1个月较前降低。TACE术后1周VEGF降低，而1个月后再次增高（P〈0．05）。免疫化疗栓塞组患者术后1周VEGF降低，至1个月后娘著低于TACE组（P〈0．05）。结论免疫化疗栓塞较TACE可有效抑制肿瘤新生血管生成，提高治疗效果。

Objective To make sure of the value of transcatheter arterial immun - chemoembolization （ICE） in VEGF of liver cancer. Methods The study was a double - blinded, coutrolled, prospective, randomized trial. Totally 146 patients in study were randomized divided into 3 groups. Group A ： regular surgery of primary liver cancer, with symptom and support treatment after surgery; Group B ： TACE 1 month after surgery, with the treatment proposal： ADM ＋ DDP ＋5 - FU ＋ LP; Group C： Transcatheter arterial immune -chemoembolization 1 month after surgery, treatment proposalis：ADM ＋ DDP ＋ 5 - FU ＋ LP ＋ Octreotide ＋ IFN. Results In Group A the level of VEGF was higher before surgery but decreased 1 month after surgery; In Group B the level of VEGF decreased 1 week after TACE, decreased significantly 4 weeks after TACE than group B （ P 〈 0.05 ）. Conclusion Transcatheter arterial immune - chemoembolization can prevent metastasis and recurrence after surgery of primary liver cancer.