肝细胞癌含洛铂化疗方案疗效及与血管内皮生长因子和凝血酶蛋白表达水平的相关性

Efficacy of Lobaplatin Containing Chemotherapeutic Regimen in Hepatocellular Carcinoma and Correlation between Hepatocellular Carcinoma with VEGF,Thrombin Protein Expression Level

目的分析血管内皮生长因子(VEGF)、凝血酶(thrombin)蛋白表达水平与肝细胞癌(HCC)的相关性及含洛铂化疗方案的临床疗效。方法收集HCC患者临床资料共120例,按照随机数字表法随机分为观察组65例和对照组55例。对照组采用含顺铂化疗方案治疗,观察组采用含洛铂化疗方案治疗。所有患者均行CT平扫及三期增强扫描;所有临床标本组织均常规采用10%的福尔马林液固定、石蜡包埋,采用免疫组化SP法测定各组VEGF及thrombin的蛋白表达水平。结果观察组65例患者中,根据CT图像的血供特征,HCC可分为少供血型组(12例)、双重供血型组(19例)及动脉供血型组(34例)3组,各组间蛋白表达阳性率差异有显著性(P<0.05);根据CT图像的侵袭特征,HCC可分为低危组(30例)和高危组(35例),其相应的VEGF及thrombin蛋白表达阳性率分别为73.33%和88.57%,36.67%和85.71%,组间差异有显著性(P<0.05);根据CT图像是否明显强化,HCC可分为明显强化组(31例)和无明显强化组(34例),组间蛋白表达阳性率差异有显著性(P<0.05);根据CT图像特征中边界是否清晰,可分为清晰型组(21例)和欠清晰型组(44例),其相应的VEGF及thrombin蛋白表达阳性率分别为71.43%和86.36%,47.62%和70.45%,组间差异有显著性(P<0.05);根据CT图像中瘤体大小,可分为瘤体直径≤5 cm组(29例)和瘤体直径>5 cm组(36例),其相应的VEGF及thrombin蛋白表达阳性率分别为82.76%和80.56%,62.07%和63.89%,组间差异无显著性(P>0.05)。观察组临床总有效率为36.92%,显著高于对照组的20.00%(P<0.05)。结论含洛铂化疗方案治疗HCC的疗效显著。CT作为诊断HCC的一种无创性检查手段,其表现特征与HCC组织中VEGF及thrombin蛋白表达水平有关,作用机制可能与VEGF及thrombin蛋白参与HCC的血管生成有关。

Objective To analyze the correlation between the VEGF and thrombin expression levels with hepatocellular carcinoma（ HCC）and the clinical efficacy of lobaplatin containing chemotherapeutic regimen. Methods The clinical data in 120 cases of HCC were collected and randomly divided into the observation group（ 65 cases） and the control group（ 55 cases） according to the random number table. The control group was treated by the cisplatin-containing regimen,while the observation group by the lobaplatin-containing chemotherapeutic regimens. All cases underwent CT plain scan and triple-phase enhanced scan; all tissue samples routinely adopted 10% formalin solution for conducting fixation and paraffin embedding; the VEGF and thrombin protein expression levels were measured by the immunohistochemical staining method. Results Among 65 cases in the observation group,HCC could be divided into the less blood supply group（ 12 cases）,dual blood supply group（ 19 cases） and the arterial blood supply group（ 34 cases） according to the blood supply characteristics in CT imaging,the positive rate of protein expression had statistically significant differences among the various groups（ P 0. 05）. According to the invasion characteristics in CT imaging, HCC could be divided into the low risk group（ 30 cases） and the high risk group（ 35 cases）, the positive rates of VEGF and thrombin protein expression were 73. 33%,88. 57% and 36. 67%,85. 71%,respectively,the differences between the two groups were statistically significant（ P 0. 05）. According to whether the CT imaging being obviously enhanced,HCC could be divided into the obvious enhancement group（ 31 cases） and the non-enhancement group（ 34 cases）,the protein expression had statistical differences between the two groups（ P 0. 05）. According to whether the tumor boundary being clear in the CT imaging,HCC could be divided into the clear boundary group（ 21 cases） and the less clear boundary group（ 44 cases）,the positive rates of VEGF and thrombin protein expression were 71. 43%,86. 36% and 47. 62%,70. 45% respectively,the differences between the two groups had statistical significance（ P 0. 05）. According to the tumor size in CT imaging,HCC could be divided into the tumor diameter≤5 cm group（ 29 cases） and the tumor diameter 5 cm group（ 36 cases）,the positive rate of VEGF and thrombin protein expression were 82. 76%,80. 56% and 62. 07%,63. 89% respectively,the differences between the two groups had no statistical significance（ P 0. 05）. The total effective rate in the observation group was 36. 92%,which was significantly higher than 20. 00% in the control group（ P 0. 05）. Conclusion The lobaplatin-containing chemotherapeutic regimen has significant effect for treating HCC,the manifestation characteristics of CT as a noninvasive examination measure for diagnosing HCC are related with the VEGF and thrombin protein expression levels in HCC tissue,its mechanism may be related with VEGF and thrombin proteins participating in HCC angiogenesis.