肝癌患者血浆PEDF和VEGF表达水平及其与预后关系的探讨

The relationship between plasma levels of pigment epithelial derived factor and vascular endothelial growth factor in the patients with hepatocellular carcinoma and prognosis

目的观察肝癌患者血浆色素上皮衍生因子(PEDF)及血管内皮生长因子(VEGF)表达水平并探讨其与预后的关系。方法采用ELISA法检测肝癌患者43例(肝癌组)、肝脏良性疾病患者20例(良性肝病组)及健康对照者20例(健康对照组)血浆PEDF和VEGF水平;肝癌患者平均随访(12.02±0.23)个月,记录短期主要不良终点事件(SMAE)发生情况。结果血浆PEDF水平肝癌组较良性肝病组及健康对照组明显降低(P<0.01),VEGF水平明显升高(P<0.01),而良性肝病组与健康对照组比较差异无统计学意义(P>0.05)。肝癌患者随访结束后,高PEDE/VEGF比值(≥3)亚组22例发生SMAE 3例(13.64%),低PEDF/VEGF比值(<3)亚组21例发生SMAE 7例(33.33%),Kaplan-Meier生存曲线显示2组差异有统计学意义(P=0.039)。另外,与未发生SMAE的肝癌患者(33例)比较,发生SMAE者(10例)有更低的PEDE/VEGF比值(2.14±0.76 vs.3.49±1.12,P<0.01)。结论 PEDF和VEGF参与肝癌的病理生理过程,低表达的PEDF及高表达的VEGF反映肝癌发生、发展及转移情况,两者比值可能成为预测肝癌转移及预后的有效指标。

Objective To observe the expression of pigment epithelium derived factor （PEDF） and vascular endothelial growth factor （VEGF） in liver cancer patients, and to explore its relationship with the prognosis. Methods ELISA was used to detect 43 cases of patients with hepatocellular carcinoma （ HCC group） , 20 patients with benign liver disease （ benign liver disease group） and 20 cases of healthy controls＇（ healthy control group） levels of plasma PEDF and VEGF levels, patients with hepatoeellular carcinoma with average follow-up （ 12.02 ±0.23 ） months, the main short recording adverse events （SMAE） occurrence were recorded. Results The levels of plasma PEDF of liver cancer group decreased than in benign liver disease group and healthy control group （ P 〈 0.01 ） , VEGF level increased significantly （ P 〈 0.01 ） , and benign disease group and the healthy control group had no significant difference （ P 〉 0.05 ）. At the end of the follow-up of patients with hepatocellular carcinoma, high ratio of PEDF/VEGF subgroup （22 eases, PEDF/VEGF ≥ 3 ） SMAE occurred in 3 patients （13.64%） , low PEDF/VEGF ratio subgroup （21 cases, PEDF/VEGF 〈 3） SMAE occurred in 7 patients （33.33%）, Ka- plan-Meier survival curve showed statistically significant differences between the 2 groups （ P = 0. 039 ）. In addition, compared with without the occurrence of SMAE in patients with hepatoeellu]ar carcinoma （33 cases）, patients with occurrence of SMAE （10 cases） with lower PEDF/VEGF ratio （2. 14 ± 0.76 vs. 3.49 ± 1.12, P 〈 0.01 ）. Conclusion PEDF and VEGF have role in the pathophysiology of hepatocel]ular carcinoma, low expression of PEDF and high expression of VEGF re- flects the development and metastasis of HCC, the ratio between the two may be an effective index to predict the metastasis and prognosis of hepatocellular carcinoma.