BCLC B期肝癌经动脉化疗栓塞术前后VEGF的表达变化及意义

Changes and significance of plasma VEGF pre-and post-transarterial chemoembolization in patients with BCLC stage B hepatocellular carcinoma

目的:观察巴塞罗那临床肝癌分期及治疗策略(Barcelona Clinic Liver Cancer Staging,BCLC)B期肝癌患者经动脉化疗栓塞术(transarterial chemoembolization,TACE)前后血管内皮生长因子(VEGF)表达水平的变化规律,探讨其可能的临床意义。方法:17例BCLC B期肝癌患者行TACE治疗。收集患者TACE术前1d及术后1、3、5、7、14、30d时外周静脉血,检测血VEGF表达水平,分析VEGF表达变化与肝癌生物学特性的关系。结果:与TACE术前1d相比,术后1d血VEGF有所升高,术后3、5d有所下降,术后14d较前均明显升高,差异有统计学意义(P<0.05)。存在肝动脉-门静脉瘘、随访CT/MRI发现明显新发病灶患者血VEGF水平较高。17例患者中疗效较好10例,疗效较差7例;两组间VEGF变化在术后14d差异有统计学意义(P<0.05)。结论:血浆VEGF表达水平可作为BCLC B期患者TACE治疗潜在的疗效评估指标。

Objective： To investigate the changes of plasma VEGF levels and its relationship with efficacy of transarterial chemoembolization （TACE） for patients with Barcelona Clinic Liver Cancer Staging （BCLC） stage B hepatocellular carcinoma,and also discuss its possible clinical significance. Methods： Peripheral blood samples were collected at 1 d before TACE and at 1,3,5,7,14, 30 d after TACE from 17 patients with BCLC stage B HCC. The relationship between plasma VEGF level and biological or imaging characteristics pre-and post-TACE were analyzed. Results ： Compared with 1 day before surgery,the VEGF level at 1 day after surgery was improved, and decreased at 3 and 5 days after surgery,but increased significantly at 14 days after surgery （P〈0 . 05）. Higher levels of plasma VEGF were observed in patients with fistula between hepatic artery and portal vein, or with tumor recurrence. Good response to TACE were observed in 10 patients, 7 patients with poor response. There were significant differences between two groups on plasma VEGF level at 14 d post-TACE（P〈0 . 05）. Conclusions ： The plasma VEGF level can be regarded as index to evaluate the efficacy of TACE for patients with BCLC B stage.