原发性肝癌患者介入治疗前后血清血管内皮生长因子的变化及其临床意义

Changes and clinical significance of plasma vascular endothelial growth factor of patients with primary liver cancer before and after interventional treatment

目的探讨中晚期原发性肝癌患者介入治疗前后血清血管内皮生长因子（VEGF）的变化及其临床意义。方法检测46例中晚期原发性肝癌患者行经肝动脉化疗栓塞术介入治疗前及治疗1个月后血清VEGF浓度，并对不同疗效患者血清VEGF浓度进行比较。检测同期健康查体者60名（正常对照组）血清VEGF浓度。结果与正常对照组比较，肝癌组患者介入治疗前血清VEGF浓度明显升高[（510．0±310．0）ng／L与（27．0±23．0）ng／L，P=0．000]。与介入治疗前比较，介入治疗后血清VEGF浓度明显降低[（316．4±240．7）ng／L与（510．0±310．0）ng／L]，两者比较差异有统计学意义（P=0．036）。介入治疗1个月后，46例患者中完全缓解4例（8．70％），部分缓解34例（73．91％），稳定6例（13．04％），进展2例（4．35％），总有效率为82．61％（38／46）。将完全缓解与部分缓解患者38例作为有效组；将稳定与进展8例患者作为无效组，有效组与无效组患者血清VEGF浓度分别为（260．6±70．5）、（346．7±61．3）ng／L，两组比较差异有统计学意义（P=0．046）。结论经肝动脉化疗栓塞术治疗原发性肝癌近期疗效较好。VEGF参与了原发性肝癌的发生发展，预后不良者血清VEGF浓度高，可作为评价疗效的参考指标。

Objective To investigate the changes of plasma vascular endothelial growth factor（VEGF） of patients of advanced primary liver cancer before and after interventional treatment and its clinical Significance. Methods Forty-six patients with advanced primary liver cancer were performed the hepatic arterial chemoembolization and served as observation group. Sixty healthy people were served as control group and measured their level of serum VEGF. The level of serum VEGF of patients in observation group before treatment and intervention 1 month were measured. Results Before interventional treatment, the serum VEGF level of observation group were （510. 0 ± 310. 0） ng/L, significantly higher than that of control group （ （27.0 ± 23.0 ） ng/L, P 〈 0. 001 ）. After interventional treatment, he serum VEGF level decreased to （316.4 ± 240. 7 ） ng/L and the difference was statistically significant （P = 0. 036）. Afte/one month interventional treatment,4 cases were complete remission （8. 70% ）, 34 cases were partial remission（73.91% ） ,6 cases were in stable （ 13.04% ） , and 2 cases were progress （4. 35% ）, and the total effective rate were 82. 61% （38/46）. The 38 cases who were complete remission and partial remission were been served as effective group, the other 8 cases were served as invalid group. The serum VEGF level in effective group were （ 260. 6 ± 70. 5 ） ng/L, lower than that in invalid group（ （ 346. 7± 61.3 ） ng/L, P = 0. 046 ） . Conclusion Hepatic arterial chemoembolization treatment on primary liver cancer curative effect is a better approach. VEGF involves in the development of primary liver cancer, and the high serum VEGF level with poor prognosis can be the reference of efficacy.