【摘要】：目的:探討原發(fā)性肝癌(Primary hepatic carcinoma,PHC)肝動(dòng)脈灌注化療栓塞術(shù)(Transcatheter arterial chemoembolization,TACE)治療前后血管內(nèi)皮生長(zhǎng)因子(Vascular endothelial growth factor,VEGF)及缺氧誘導(dǎo)因子-1α(Hypoxia-inducible factor-1α,HIF-1α)的變化及意義。對(duì)象與方法:運(yùn)用雙抗體夾心酶聯(lián)免疫吸附法(Enzyme-linked immune-sorbent assay,ELISA)檢測(cè)25例健康志愿者(對(duì)照組)外周靜脈血血清中VEGF及HIF-1α的水平,及43例PHC(觀察組)在TACE術(shù)前1天、術(shù)后1天、術(shù)后7天及術(shù)后28天的外周靜脈血血清中VEGF及HIF-1α的水平,分析對(duì)照組與觀察組VEGF及HIF-1α的水平差異及觀察組TACE治療后VEGF及HIF-1α水平的動(dòng)態(tài)變化規(guī)律。采用免疫組織化學(xué)(Immunohistochemistry,IHC)Elivison法檢測(cè)61例PHC組織(TACE治療組21例,對(duì)照組40例)中VEGF與HIF-1α的表達(dá),分析TACE治療對(duì)肝癌VEGF與HIF-1α表達(dá)的影響。結(jié)果:對(duì)照組及觀察組(TACE術(shù)前1天)血清VEGF和HIF-1α的含量分別為(81.12±30.55)pg/ml、(292.64±87.13)pg/ml和(40.34±17.71)pg/ml、(184.78±83.04)pg/ml,觀察組VEGF和HIF-1α的含量均顯著高于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(p0.05)。觀察組TACE術(shù)前血清VEGF與HIF-1α呈正相關(guān)(r=0.56,p0.05)。觀察組VEGF和HIF-1α的含量在術(shù)前1天、術(shù)后1天、7天和28天分別為(292.64±87.13)pg/ml、(432.83±106.10)pg/ml、(389.18±61.01)pg/ml、(289.45±86.75)pg/ml和(184.78±83.04)pg/ml、(462.83±117.80)pg/ml、(270.76±94.38)pg/ml、(192.35±79.43)pg/ml,差異具有統(tǒng)計(jì)學(xué)意義(F=31.12,p=0.000和F=122.94,p=0.000),其中,VEGF和HIF-1α在TACE術(shù)后1天和7天均顯著升高,在TACE術(shù)后28天恢復(fù)到術(shù)前水平。CR+PR組的VEGF和HIF-1α水平在術(shù)前1天、術(shù)后28天分別為(343.02±74.57)pg/ml、(227.32±91.01)pg/ml和(209.90±62.69)pg/ml、(149.73±26.76)pg/ml,VEGF和HIF-1α水平在術(shù)后均顯著降低(p0.05);而SD+PD組的VEGF和HIF-1α水平在術(shù)前1天、術(shù)后28天分別為(265.27±85.18)pg/ml、(308.77±79.67)pg/ml和(173.89±89.16)pg/ml、(210.82±87.60)pg/ml,VEGF和HIF-1α水平在術(shù)后均顯著升高(p0.05)。TACE治療組與對(duì)照組VEGF和HIF-1α的陽(yáng)性表達(dá)率分別為71.4%(15/21)、65.0%(26/40)和61.9%(13/21)、55.0%(22/40),差異均無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.258,p=0.611和χ2=0.268,p=0.604)。結(jié)論:肝癌TACE治療后VEGF和HIF-1α水平將發(fā)生動(dòng)態(tài)變化。研究肝癌TACE治療后VEGF和HIF-1α水平變化規(guī)律,對(duì)于評(píng)價(jià)肝癌TACE治療療效具有重要價(jià)值。
[Abstract]:Objective: to investigate vascular endothelial growth factor (Vascular endothelial growth factor,VEGF (Vascular endothelial growth factor,VEGF) and hypoxia inducible factor-1 偽 (Hypoxia-inducible factor-1 偽) in primary liver cancer (Primary hepatic carcinoma,PHC) before and after hepatic arterial infusion chemoembolization (Transcatheter arterial chemoembolization,TACE). The change and significance of HIF-1 偽). Participants and methods: the levels of VEGF and HIF-1 偽 in peripheral venous blood of 25 healthy volunteers (control group) were detected by double antibody sandwich enzyme-linked immunosorbent assay (Enzyme-linked immune-sorbent assay,ELISA). And 43 cases of PHC (observation group) at 1 day before TACE, 1 day after operation, 7 days after operation and 28 days after operation, the levels of VEGF and HIF-1 偽 in peripheral venous blood of 43 patients (observation group) were 1 day before operation, 1 day after operation, 7 days after operation and 28 days after operation. The differences of VEGF and HIF-1 偽 levels between the control group and the observation group and the dynamic changes of VEGF and HIF-1 偽 levels after TACE treatment in the observation group were analyzed. The expression of VEGF and HIF-1 偽 in 61 cases of PHC (21 cases in TACE treatment group and 40 cases in control group) was detected by Immunohistochemistry,IHC Elivison method, and the effect of TACE treatment on the expression of VEGF and HIF-1 偽 in HCC was analyzed. Results: the levels of serum VEGF and HIF-1 偽 in the control group and the observation group (1 day before TACE) were (8.1 12 鹵30. 55) pg/ml, (292.64 鹵87. 13) pg/ml and (40. 34 鹵17. 71) pg/ml, (184.78 鹵83. 04) pg/ml, respectively. The contents of VEGF and HIF-1 偽 in the observation group were significantly higher than those in the control group (p0.05). There was a positive correlation between serum VEGF and HIF-1 偽 before TACE in the observation group (r 鈮，

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