肝癌患者血清血管内皮生长因子和内皮抑素水平的变化及意义

Fluctuation and Clinical Significance of Serum Levels of VEGF and Endostatin in Patients with Hepatocellular Carcinoma

目的研究肝癌患者血清血管内皮生长因子(VEGF)和内皮抑素(endostatin)的动态变化规律及其与临床病理特征的关系。方法用ELISA法检测163例原发性肝癌患者(肝癌组)血清VEGF和内皮抑素水平,并与慢性乙型肝炎肝硬化(肝硬化组)和健康人群(正常对照组)做对比。另外,比较117例行外科手术和(或)介入手术的原发性肝癌患者术前及术后2周VEGF和内皮抑素水平的变化。结果肝癌组患者血清VEGF和内皮抑素水平显著高于肝硬化组和正常对照组,差异有统计学意义(P<0.01);术后2周血清VEGF水平较术前均显著下降,而血清内皮抑素水平较术前显著升高,差异有统计学意义(P<0.01)。肝癌患者血清VEGF、内皮抑素水平与肿瘤大小、有无门静脉癌栓及临床分期密切相关(P<0.01),而与性别、是否合并肝硬化无相关性(P>0.05)。肝癌组患者术前内皮抑素水平与VEGF水平呈正相关(r=0.658,P<0.01)。结论肝癌患者血清VEGF和内皮抑素水平升高,且与肿瘤大小及临床分期密切相关,可作为诊断和评价肝癌发生、发展的指标。

Objective To investigate the fluctuation of serum levels of vascular endothelial growth factor（VEGF） and Endostatin in patients with hepatocellular carcinoma and its relationship with clinicopathological features of the disease.Methods Serum levels of VEGF and endostatin were measured using enzyme-linked immunoassay（ELISA） in 163 patients with hepatocellular carcinoma and compared with those of both the hepatitis B induced cirrhosis patients（cirrhosis group） and the healthy subjects（control group）.In addition,preoperative and postoperative levels of VEGF and endostatin were compared in 117 cases who had undergone surgical and/or interventional operation.Results Levels of VEGF and endostatin in patients with hepatocellular carcinoma were significantly higher than those in patients with posthepatitic cirrhosis and healthy persons（P0.01）.Preoperative levels of VEGF and endostatin were closely related to tumor size,presence of portal vein tumor thrombus,and clinical staging（P0.01）.Postoperative VEGF levels were significantly reduced after the operation（P0.01）,while postoperative endostatin levels were significantly enhanced（P0.01）.Conclusion The elevated levels of VEGF and endostatin in patients with hepatocellular carcinoma are closely correlated to tumor size and clinical staging,which may be useful in evaluating the existence and biological behaviors of hepatocellular carcinoma preoperatively.