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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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

Received: 16 October 2020

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R735.7

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

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