【摘要】 目的研究重组人血管内皮抑素注射液(YH216恩度)联合TACE治疗中晚期肝癌对VEGF表达的影响。方法 采用随机对照法,将30例临床诊断HCC的患者随机分为A、B两组,A组(研究组15例)采取TACE联合恩度治疗,B组(对照组15例)采取单纯TACE术治疗,所有病例均于术前7天及术后第3、7、21、35天时分别抽静脉血,用ELISA法定量检测血清中VEGF的表达水平。结果 TACE术前两组患者VEGF水平差异无统计学意义(P>0.05),A组患者的VEGF水平于术后第3天略有升高,术后7天、21天、35天表现为持续降低,且低于术前水平;B组患者的VEGF水平仅在术后21天略降低,术后3天、7天、35天均较术前增高,两组治疗后各时间点与术前差异均有统计学意义(P<0.05)。肿瘤直径<5 cm的患者,A组TACE术后的VEGF水平于第3天略升高,之后持续明显降低,且持续时间长,B组患者术后7天开始降低,术后35天又开始升高;肿瘤直径>5 cm的患者,A组仅于术后第3天升高,其余时间点均低于术前水平,B组仅于术后第21天低于术前水平。结论 TACE联合恩度能降低原发性肝癌TACE术后VEGF水平,对肿瘤<5 cm的患者效果显著。更多还原

【Abstract】 Objective To investigate the plasma vascular endothelial growth factor(VEGF) levels of recombinant human endostar combined with transcatheter arterial chemoembolization(TACE) in treatment of hepatocellular carcinoma(HCC). Methods Thirty patients with HCC were treated with recombinant human endostar combined with TACE(trial group) or TACE alone(control group) with 15 cases in each group.Venous blood samples of 30 patients collected on the 7th day preoperatively,and the 3rd,7th,21th,35th days postoperatively,were used to examine the plasma VEGF levels with ELISA quantitatively. Results The plasma VEGF levels preoperatively was no statistically significant difference(P>0.05) in two groups.The plasma VEGF levels of trial group were slightly elevated on the 3rd day postoperatively,manifested as a continual decrease on the 7th,21th,35th days postoperatively and lower than preoperative levels.The plasma VEGF levels of control group slightly decreased on the 21th day postoperatively only,but increased on other postoperative days and higher than preoperative VEGF levels.There were significant differences of VEGF levels between any time points postoperatively and preoperatively(P<0.05).VEGF levels of the patients with tumor diameter < 5 cm in trial group increased slightly on the 3rd day postoperatively,then reduced continually,and lasted for a long time.But patients in control group began to drop on the 7th day postoperatively,and began to rise on the 35th day.VEGF levels of the patients with tumor diameter >5 cm in trial group only increased on the 3rd day,at the rest of the time point are lower than preoperative VEGF level,but the levels of the patients in control group were only lower than preoperative VEGF level on the 21th day postoperatively. Conclusion Endostar combined with TACE can reduce the VEGF levels of hepatocellular carcinoma,especially for the patients with tumor diameter <5 cm.更多还原