中晚期原发性肝癌患者TACE术后血管内皮生长因子受体表达与疗效的关系

doi:10.3969/j.issn.1671-7171.2021.08.003

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摘要【目的】探讨中晚期原发性肝癌(PHC)患者经导管动脉化疗栓塞(TACE)术后血管内皮生长因子受体(VEGFR)的表达与疗效的关系。【方法】本院收治的83例中晚期PHC患者,均行TACE治疗,按照近期临床疗效将患者分为临床控制者与临床未控制者,比较术前1 d、术后5 d两者血清VEGFR-2、VEGFR-3水平;分析中晚期PHC患者近期疗效与血清VEGFR-2、VEGFR-3水平的关系,比较△VEGFR-2减少者、△VEGFR-3减少者与未减少者的临床病理特征。随访1年,采用Kaplan-Meier法绘制生存曲线,采用log-rank检验分析△VEGFR-2和△VEGFR-3与总生存期(OS)的关系,以受试者工作曲线(ROC)分析△VEGFR-2和△VEGFR-3水平预测PHC患者死亡的价值。【结果】临床控制者与临床未控制者术后5 d血清VEGFR-2、VEGFR-3水平均低于术前1 d(P<0.05),临床控制者△VEGFR-2减少率、△VEGFR-3减少率均高于临床未控制者(P<0.05)。△VEGFR-2、△VEGFR-3未减少者Child-Pugh分级为B级占比、血清AFP、VEGF水平、合并肝硬化占比、肿瘤大小均比△VEGFR-2、△VEGFR-3减少者高(P<0.05)。随访1年,△VEGFR-2减少者的OS高于未减少者(Log Rankχ²=10.428,P=0.001)。△VEGFR-3减少者的OS高于未减少者(Log Rank χ²=4.696,P=0.030)。ROC曲线结果显示,△VEGFR-2、△VEGFR-3、△VEGFR-2联合△VEGFR-3预测PHC患者死亡的曲线下面积(AUC)分别为0.777、0.756、0.915(P<0.05)。【结论】中晚期PHC患者TACE术前1 d、术后5 d血清VEGFR-2、VEGFR-3水平与疗效密切相关,△VEGFR-2、△VEGFR-3可用于预测中晚期PHC患者的生存情况。

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关键词 ：肝肿瘤/外科学, 肝肿瘤/放射疗法, 栓塞, 血管内皮生长因子类, 预后

Abstract：【Objective】To investigate the relationship between the expression of vascular endothelial growth factor receptor (VEGFR) and the efficacy of patients with advanced primary liver cancer (PHC) after transcatheter arterial chemoembolization (TACE). 【Methods】A total of 83 PHC patients were selected as the research subjects. All patients were treated with TACE. The patients were divided into the clinically controlled and clinically uncontrolled patients according to the recent clinical efficacy. The serum VEGFR-2 and VEGFR-3 levels of clinically controlled and clinically uncontrollable patients at 1 d before operation and 5 d after operation were compared, and the relationship of the short-term curative effect with serum VEGFR-2 and VEGFR-3 levels in PHC patients were analyzed. The clinicopathological characteristics were evaluated among cases with VEGFR-2/VEGFR-3 reduction and without reduction. Patients were followed up for 1 year. Kaplan-Meier method was used to draw the survival curve and the log-rank test was used to analyze the relationship of △VEGFR-2 and △VEGFR-3 with overall survival (OS).ROC was used to analyze the value of △VEGFR-2 and △VEGFR-3 in predicting the death of PHC patients. 【Results】The levels of serum VEGFR-2 and VEGFR-3 in all patients after TACE were lower than those on the first day before surgery (P<0.05). The reduction rates of △VEGFR-2 and △VEGFR-3 in clinically controlled patients were both higher than those under clinically uncontrolled (P<0.05).Patients without VEGFR-2 and △VEGFR-3 reduction showed higher proportion of Child-Pugh grade B, serum AFP level, VEGF level, the proportion of combined liver cirrhosis, and the tumor size than those with △VEGFR-2 and △VEGFR-3 reduction (P<0.05).After 1-year follow-up, the overall survival rate (OS) of patients with reduced △VEGFR-2 was higher than that of VEGF2 unreduced cases (Log Rankχ² =10.428, P=0.001). △VEGFR-3 reduced patients had a higher OS than unreduced ones (Log Rank χ²=4.696, P=0.030).ROC curve results showed that the area under the curve (AUC) of △VEGFR-2, △VEGFR-3, △VEGFR-2 combined with △VEGFR-3 to predict death of PHC patients were 0.777, 0.756, 0.915, respectively (P<0.05). 【Conclusion】The levels of serum VEGFR-2 and VEGFR-3 in patients with advanced PHC at 1 day before TACE and 5 days after operation are closely related to the efficacy. And △VEGFR-2 and △VEGFR-3 can be used to predict the survival of patients with advanced PHC.

Key words： Liver Neoplasms /SU Liver Neoplasms /RT Embolism Vascular Endothelial Growth Factors Prognosis

收稿日期: 2020-10-16

中图分类号:

R735.7

基金资助:上海市科委科研项目(19441905000

通讯作者: ** E-mail:toewe@hotmail.com

引用本文:

王晖, 汤旻, 沈颖, 黄雷, 唐文贤. 中晚期原发性肝癌患者TACE术后血管内皮生长因子受体表达与疗效的关系[J]. 医学临床研究, 2021, 38(8): 1128-1131.
WANG Hui, TANG Min, SHEN Ying, et al. Relationship between the Expression of Vascular Endothelial Growth Factor Receptor and Therapeutic Effect in Patients with Advanced PHC after TACE. JOURNAL OF CLINICAL RESEARCH, 2021, 38(8): 1128-1131.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.08.003 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I8/1128

[1] LIU Z, XU K, JIANG Y, et al. Global trend of aetiology-based primary liver cancer incidence from 1990 to 2030: a modelling study[J].Int J Epidemiol,2021, 50(1):128-142.
[2] 申明,张铭光,王瑞,等. TACE治疗老年原发性肝癌的近远期疗效及血清bFGF、 CTC水平变化分析[J].标记免疫分析与临床,2020,27(4):563-566.
[3] MORSE M A, SUN W, KIM R, et al. The role of angiogenesis in hepatocellular carcinoma[J].Clin Cancer Res,2019,25(3):912-920.
[4] HOU Z H, XU X W, FU X Y, et al. Long non-coding RNA MALAT1 promotes angiogenesis and immunosuppressive properties of HCC cells by sponging miR-140[J].Am J Physiol Cell Physiol,2020,318(3):649-663.
[5] 中国抗癌协会肝癌专业委员会, 中华医学会肝病学分会肝癌学组, 中国抗癌协会病理专业委员会, 等.原发性肝癌规范化病理诊断指南(2015年版)[J].中华肝胆外科杂志, 2015, 21(3):145-151.
[6] 陈丹,王凯冰,李加桩, 等.血清VEGFR-2浓度变化预测肝癌患者TACE近期疗效的研究[J].中国肿瘤,2017,26(6):476-481.
[7] LIU Z, SUO C, MAO X, et al. Global incidence trends in primary liver cancer by age at diagnosis, sex, region, and etiology, 1990-2017[J].Cancer,2020, 126(10):2267-2278.
[8] KWON S M, BUDHU A, WOO H G, et al. Functional genomic complexity defines intratumor heterogeneity and tumor aggressiveness in liver cancer[J].Sci Rep,2019, 9(1):169-178.
[9] 杨秀成,于琼,巩林强,等. 结肠癌血清IGF-1水平及肿瘤组织中VEGF-C、VEGFR-3表达与淋巴结转移的相关性研究[J].分子诊断与治疗杂志,2020,12(3):381-385.
[10] 郭嘉欣,李梦琪,尚静,等. 硫酸右旋糖苷通过下调血管内皮生长因子/血管内皮生长因子受体2表达和M2型巨噬细胞浸润抑制胃癌血管生成的研究[J].实用医学杂志,2020,36(17):2365-2370.
[11] 孙岩岩,陈之显,李广恩,等. 丹参酮通过VEGF/VEGFR信号通路抑制肝癌细胞迁移和侵袭能力的实验研究[J].现代生物医学进展,2020,20(16):3033-3037.
[12] 赖文芳,黄鑫,刘俊杰,等. 片仔癀调控膜联蛋白A1/VEGF通路对人肝癌细胞系HepG2作用的影响[J].中国药理学通报,2019,35(11):1534-1538.
[13] SHIGETA K, DATTA M, HATO T, et al. Dual programmed death receptor-1 and vascular endothelial growth factor receptor-2 blockade promotes vascular normalization and enhances antitumor immune responses in hepatocellular carcinoma[J].Hepatology,2020,71(4):1247-1261.
[14] 徐新宝,殷杰,吉浩明,等. S-TACE联合阿帕替尼对中晚期原发性肝癌患者肿瘤血管因子、肝功能和预后的影响[J].肝脏,2020,25(9):933-936.