VEGF和MVD在术前接受过肝动脉栓塞化疗的肝癌组织中的表达及临床意义

目的探讨血管内皮细胞生长因子(VEGF)和平均微血管密度(MVD)在接受术前经导管肝动脉栓塞化疗(TACE)肝癌细胞中的表达和在二期切除肝癌复发预后中的意义。方法选取91例术前TACE和50例未行TACE肝癌手术切除标本,采用免疫组化方法检测两组标本VEGF、CD34的表达情况和MVD值。分析两组VEGF的表达情况和MVD值的差异,以及62例术前TACE后根治性切除的肝癌中VEGF的表达水平与复发的关系。结果 VEGF表达于肝细胞质中,CD34选择性表达于血管内皮细胞,术前TACE组和未行TACE组VEGF的表达(6.9±4.7vs5.1±4.4)和MVD值(62.0±35.4vs45.6±29.0)差异有统计学意义(P0.05)。术前TACE后根治性二期切除患者,复发组(45例)与未复发组(17例)肿瘤组织中VEGF阳性率分别为82.2%和41.2%,差异有统计学意义(P0.05)。VEGF阳性组1、3、5年无瘤生存率分别为50.9%、%、22.5%,VEGF阴性组分别为88.5%、68.2%、28.153.0%,差异有统计学意义(P0.05)。多因素分析表明治疗前存在播散结节及VEGF的表达水平是影响TACE后二期切除患者复发的独立危险因素。结论 TACE后残癌组织血管生成增多,术前TACE后二期根治性切除肝癌VEGF的表达与患者术后复发转移密切相关。

Expression and significance of VEGF and MVD in hepatocellular carcinoma patients received preop-erative transcatheter arterial embolization

Objective To study the expression and significance of vascular endothelial growth factor（VEGF）and microvessel density（MVD）in hepatocellular carcinoma（HCC）patients underwent preoperative transcatheter arterial embolization（TACE）.Methods The expressions of VEGF and CD34 in 91 specimens of HCC with preoperative TACE（TACE group）and 50 specimens of HCC（non-TACE group）were detected by im-munohistochemistry method.The expressions of VEGF and CD34 between the two groups were compared.Correlations of VEGF expression to the recurrence were analyzed.Results VEGF was expressed in cytolymph and CD34 was expressed in vascular endothelial cell.Expressions of VEGF was significantly higher in TACE group than that in non-TACE group,6.9±4.7 vs 5.1±4.4,P0.05,did MVD,62.0±35.4 vs 45.6±29.0,so P0.05.In patients who underwent curative resection after preoperative TACE,the positive rates of VEGF were significantly higher in recurrent group than in non-recurrent group,82.2% vs 41.2%,P0.05.The 1-,3-,and 5-year disease-free survival rates in VEGF-negative group were significantly higher than that in VEGF-positive group,88.5% vs 50.9%,68.2% vs 28.1%,and 53.0% vs 22.5%,0.05.Multivariate analysis revealed that P preoperative disseminated nodes and the expression of VEGF were independent recurrence risk factors.Conclu-sions There is more angiogenesis and potentiality of recurrence and metastasis in tumor tissues of HCC patients after TACE.The expression of VEGF is closely correlated to postoperative recurrence of HCC patients who un-derwent preoperative TACE.