重组人血管内皮抑制素联合TACE治疗对肝癌血管的影响

Anti-angiogenesis effect of recombinant human edostatin combined with TACE in primary hepatocellular carcinoma

目的探讨重组人血管内皮抑制联合肝动脉化疗栓塞术(TACE)对原发性肝癌内皮生长因子(VEGF)表达和肿瘤微血管密度(MVD)的影响。方法 46例中晚期原发性肝癌患者随机分为对照组(20例)和治疗组(26例),对照组单纯给予TACE治疗,治疗组给予重组人血管内皮抑制素联合TACE治疗。利用免疫组化法检测治疗前、后VEGF的表达变化和MVD。ELISA法检测治疗前后血清VEGF的表达水平,并进行比较。结果治疗组术后7d、30d血浆VEGF水平(292.34±70.74)pg/ml、(189.49±72.66)pg/ml与对照组(371.36±81.20)pg/ml、(319.24±70.54)pg/ml比较呈明显降低,差异有显著性(t=2.149,P<0.05)。术后30d治疗组和对照组的VEGF表达强度分别为(158.4±38.9)和(60.75±14.0),和MVD分别为(56.6±15.1)和(21.7±6.1),两组比较差异有显著性(t1=2.576、t2=2.328、P均<0.05)。结论 TACE联合重组人血管内皮抑制素治疗明显降低肝癌VEGF表达和MVD,对肿瘤再生血管有一定抑制的作用,巩固和加强了TACE的治疗。

Objective To study the expression of microvascular density （MVD）and vascular endothelial growth factor （VEGF）in primary hepatocellular carcinoma after transcatheter arterial chemoembolization （TAC）combining recombinant human endostatin. Methods Forty-six primary hepatocellular carcinoma patients were divided into control group（n=20） only treated with TACE,and the treatment group （n=26）treated with recombinant human endostafin by hepatic artery embolization on the base of control group. The expression of vascular endothelial growth factor （VEGF）and microvessel density（MVD）in primary hepatocellular carcinoma were detected by immunohistochemistry assay before and after treatment, changes in levels of serum VEGF were detected by ELISA and compared before and after the treatment. Results The plasma VEGF levels in treatment group and control group 7 days,and 30 days after treatment showed significant difference （P〈0.05）. Tthe intensity of VEGF expression and MVD in the treatment group 30 days after treatment was significantly lower than the control group （P〈0.05）. Conclusions TACE in combination with recombinant human endostatin can significantly reduce the expression of VEGF and MVD and inhibit the angiogenesis of tumor.