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目的:探讨动脉内重组人血管内皮抑制素(recombinant human endostatin,rh-endostatin)及化疗栓塞(transarterial chemoembolization,TACE)治疗原发性肝癌(hepatocellular carcinoma,HCC)对血浆血管内皮生长因子(vascular endothelial growthfactor,VEGF)表达的动态变化。方法:40例临床诊断为HCC的患者,随机分成2组,各20例,分别用rh-endostatin加TACE术或单纯TACE术治疗,所有病例均于TACE术前、术后3、7 d及1个月时抽血,用ELISA法定量检测血浆中VEGF的表达水平。结果:rh-endostatin加TACE术组HCC患者血浆中VEGF表达水平术后3 d明显升高,与术前比较差异有统计学意义(P=0.019),术后7 d、1个月血浆中VEGF表达水平下降至与术前比较差异无统计学意义(P=0.577及P=0.740);单纯TACE术组HCC患者血浆VEGF表达水平在术后3 d、术后7 d逐渐升高,与术前比较差异有统计学意义(P=0.014及P=0.002),术后1个月血浆VEGF表达水平逐渐下降,与术前比较差异无统计学意义(P=0.710)。结论:通过动态检测2组HCC患者血浆VEGF的表达水平,反映了rh-endostatin对血浆VEGF表达的影响,间接说明rh-endostatin对肿瘤血管生成有一定的抑制作用。
Objective: To investigate the effects of recombinant human endostatin (rh-endostatin) and transarterial chemoembolization (TACE) on the proliferation of vascular endothelial growth factor (VEGF) in primary hepatocellular carcinoma (HCC) , VEGF) expression of dynamic changes. Methods: Forty patients with HCC were randomly divided into two groups (n = 20 each). The patients were treated with rh-endostatin plus TACE or TACE alone. All patients were treated with TACE, 3 and 7 d and 1 Blood samples were taken at month, and the levels of VEGF in plasma were quantitatively determined by ELISA. Results: The plasma levels of VEGF in rh-endostatin plus TACE group were significantly increased at 3 days after operation (P = 0.019). The levels of VEGF (P = 0.577 and P = 0.740). The plasma levels of VEGF in HCC patients in simple TACE group increased 3 d after operation and gradually increased at 7 d after operation, which were significantly lower than those before operation The difference was statistically significant (P = 0.014 and P = 0.002). The level of plasma VEGF decreased gradually at 1 month after operation, showing no significant difference compared with that before operation (P = 0.710). Conclusion: The dynamic changes of VEGF expression in two groups of patients with HCC can reflect the effect of rh-endostatin on the expression of VEGF, which indirectly shows that rh-endostatin can inhibit tumor angiogenesis.