TACE治疗对原发性肝癌患者血HIF-1α、骨桥蛋白表达的影响

Effect of TACE treatment on expression of serum HIF-1α and OPN in patients with hepatocellular carcinoma

目的:探究肝动脉化疗栓塞(TACE)治疗前后原发性肝癌患者血缺氧诱导因子-1α(HIF-1α)、骨桥蛋白的变化及意义。方法:原发性肝癌患者35例,采用ELISA检测TACE治疗前、治疗后2d、治疗后30d外周血HIF-1α、骨桥蛋白的动态变化,15名体检者为健康对照组。结果:TACE治疗前肝癌患者外周血HIF-1α为(2562±656)pg/ml、骨桥蛋白为(123±30)μg/L,显著高于健康对照组的(1963±61)pg/ml和(34±12)μg/L(P均(0.01);且上述2指标水平有癌栓组分别为(3020±752)pg/ml和(137±23)μg/L,表达高于无癌栓组的(2294±430)pg/ml和(119±33)μg/L(P均(0.05);有远处转移组为(2985±696)pg/ml和(146±28)μg/L,高于无转移组的(2341±497)pg/ml、(115±27)μg/L(P均(0.05)。TACE治疗后2d患者血清HIF-1α和骨桥蛋白为(3001±985)pg/ml、(170±68)μg/L,较治疗前升高(P均(0.05);TACE治疗后30d患者外周血HIF-1α(2150±289)pg/ml和骨桥蛋白(108±31)μg/L较治疗前、治疗后2d下降(P均(0.05)。肝癌患者外周血HIF-1α、骨桥蛋白的表达明显相关(r=0.983,P(0.05)。结论:TACE治疗后肝癌患者血HIF-1α、骨桥蛋白短期内升高,可能与肿瘤血管栓塞后加重肿瘤的缺氧微环境有关,但术后30d内下降,提示TACE在治疗肿瘤的同时未增加肝癌的侵袭性。

Objective：To explore the expression changes of serum hypoxia inducible factor-1α（HIF-1α） and osteopontin（OPN） in patients with primary hepatocellular carcinoma（HCC） before and after the treatment of transhepatic artery chemoembolization（TACE）and define their clincal significance.Methods：The serum levels of HIF-1α and OPN in 35 cases with HCC 1 d before TACE,2 d and 30 d after TACE were measured by ELISA,with 15 cases of healthy persons as a healthy control group.Results：Compared with control group [（1963±61）pg/ml and（34±12）μg/L],both the serum HIF-1α and OPN expression levels increased significantly（P﹤0.01）in patients with HCC before TACE [（2 562±656）pg/ml and（123±30）μg/L seperately];And the levels of the above-mentioned two indicators in the group of patients with tumor thrombi [（3 020±752）pg/ml and（137±23）μg/L,seperately] were significantly higher than that in the group of patients without tumor thrombi [（2 294±430）pg/ml and（119±33）μg/L]（P0.05）;The levels in patients with metastasis（2 985±696）pg/ml and（146±28）μg/L were significantly higher than that in patients without metastasis [（2 341±497） pg/ml and（115±27）μg/L,seperately]（P0.05）.On the 2nd day after TACE,the levels of serum HIF-1α（3 001±985）pg/ml and OPN（170±68）μg/L were even higher than that before treatment（P0.05）;Thirty days later,compared with before and 2 d after TACE,both levels of serum HIF-1α（2 150±289） pg/ml and OPN（108±31）μg/L significantly declined（P0.05）.There were significantly correlation between the expression level of HIF-1α and that of OPN in patients with HCC（r=0.983,P﹤0.05）.Conclusion：The short-term increased expressions of HIF-1αand OPN after TACE is possibly related with the hypoxia microenvironment aggravated by TACE,but their expressions declined 30 d after the treatment,which prompt TACE did not increase liver cancer invasion during the treatment of primary hepatocellular carcinoma.