扶正消瘤颗粒对原发性肝癌血清中VEGF、HIF-1α表达的影响及临床意义

Effects of Fuzheng Xiaoliu Granule on the Expression of VEGF and HIF-1α in Serum of Primary Hepatocellular Carcinoma and Its Clinical Significance

目的探讨扶正消瘤颗粒对原发性肝癌血清中血管内皮生长因子(Vascular endothelial growth factor,VEGF)和缺氧诱导因子-1α(Hypoxia inducible factor-1α,HIF-1α)表达的影响及临床意义。方法选择符合纳入标准的原发性肝癌患者66例,按1∶1随机分试验组和对照组。观察治疗过程中两组VEGF、HIF-1α水平的变化及对患者临床疗效指标的影响。结果①在性别、年龄、合并乙型肝炎、Child-Pugh分级、AFP值、临床分期方面,试验组和对照组差异无统计学意义(P>0.05)。②肝癌患者在治疗各时间节点的VEGF和HIF-1α表达水平呈线性正相关(r=0.829,P<0.001)。③VEGF浓度在经导管动脉化疗栓塞术(Transcatheter arterial chemoembolization,TACE)后3月降至术前水平(P>0.05),HIF-1α在TACE后3月仍高于术前(P<0.05)。④扶正消瘤颗粒可降低HIF-1α水平,下调VEGF的表达。⑤扶正消瘤颗粒可减少TACE序贯RFA治疗后的不良反应,提高患者的生活质量(P<0.05)。⑥血清中VEGF水平与生活质量无明显相关性(P>0.05,r=0.251),HIF-1α水平与生活质量存在正相关性(P<0.05,r=0.450)。结论扶正消瘤颗粒可明显改善TACE序贯RFA治疗后患者生活质量,降低HIF-1α水平,下调VEGF的表达,抑制肿瘤血管生成。

Objective To investigate the effect of Fuzheng Xiaoliu Granules on the expression of vascular endothelial growth factor(VEGF) and hypoxia inducible factor-1α(HIF-1α) in the serum of primary hepatocellular carcinoma and its clinical significance. Methods A total of 66 patients with primary hepatocellular carcinoma who met the inclusion criteria were randomly divided into an experimental group and a control group. The changes of VEGF and HIF-1α levels in the 2 groups during treatment and the effect on the clinical efficacy indicators of the patients were observed.Results① There was no statistically significant difference between the experimental group and the control group in terms of gender, age, combined hepatitis B, Child-Pugh classification, AFP value, and clinical stage(P >0.05). ② A positive linear correlation was detected between VEGF and HIF-1α expression levels in patients with liver cancer at each time point of treatment(r = 0.829, P< 0.001). ③ VEGF concentration fell to preoperative levels 3 months after transcatheter arterial chemoembolization(TACE)(P >0.05), and HIF-1α remained higher than that before 3 months after TACE(P<0.05). ④ Fuzheng Xiaoliu Granules can reduce the HIF-1α levels and down-regulate the expression of VEGF. ⑤Fuzheng Xiaoliu Granules can reduce the adverse reactions after TACE sequential RFA treatment and improve patients′quality of life(P< 0.05). ⑥ There was no significant correlation between serum VEGF level and quality of life(P >0.05,r = 0.251), and there was a positive correlation between HIF-1α level and quality of life(P< 0.05, r = 0.450).Conclusion Fuzheng Xiaoliu Granules can significantly improve the quality of life of patients after sequential TACE RFA treatment, reduce HIF-1α level, down-regulate the expression of VEGF, and inhibit tumor angiogenesis.