肝右叶前、后段原发性肝癌TACE后VEGF及CD34的表达水平  

The expression levels of vascular endothelial growth factor and CD34 in residual cancerous tissues of primary hepatoceilular carcinoma located at anterior and posterior segments of right lobe liver after TACE

作　　者：沈海洋[1] 刘瑞宝[1] 刘岩[1] 杨奕[1] 孙厚宾[1] 王惠文[1] 李凯[1] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院介入科,哈尔滨150081

出　　处：《介入放射学杂志》2012年第6期469-472,共4页Journal of Interventional Radiology

摘　　要：目的探讨肝右叶后段原发性肝癌病灶较前段易发生侧支循环的可能机制。方法取经导管肝动脉化疗栓塞术(TACE)后手术切除的肝细胞癌组织标本57份和未经任何治疗直接手术切除的肝细胞癌组织标本40份(单纯手术组),按影像学检查符合筛选标准3l例分两组。A组:13例,病灶位于肝右叶前段(V、Ⅷ段);B组:18例,病灶位于肝右后段(Ⅵ、Ⅶ段)。采用免疫组化联酶卵白素染色(SP)法,检测残癌组织血管内皮生长因子(VEGF)表达水平和微血管密度[MVD(CD34标记)]。结果 TACE组VEGF蛋白阳性表达率显著高于单纯手术组,分别为86.0%和65.0%,差异有统计学意义(p=0.015);TACE组MVD值较单纯手术组显著增高,分别为79.37±15.36和43.23±14.98,差异有统计学意义(p=0.000)。TACE组VEGF蛋白阳性表达与MVD值变化呈正相关(r_s=0.493,P<0.01)。B组病灶周围MVD略高于A组,分别为80.44±13.74和78.08±15.33,但差异无统计学意义(P>0.05)。结论 TACE诱导的新生血管生成理论可能并非肝右叶前后段病灶侧支循环建立差异的机制。Objective To discuss the possible mechanism of why the posterior segments of right hepatic lobe were more prone to form collateral circulation than the anterior segments in primary hepatocellular carcinoma （HCC） after transcatheter arterial chemoembolization （TACE）. Methods Fiftyseven HCC cases who received second-stage surgery after TACE were taken as TACE group, while forty HCC cases who received only surgery were taken as pure surgery group. The surgical specimens were collected in all cases. In TACE group, 31 cases were up to the screening criteria. According to CT or MRI imaging, these 31 cases were divided into two groups. Group A （n = 13）： the lesions were located at anterior segments （V, VIII） of the fight lobe. Group B （n = 18） ： the lesions were located at posterior segments （VI, VII） of the right lobe. Vascular endothelial growth factor （VEGF） and microvessel density （MVD, labeled with CD34） were determined by using immunohistochemical methods. Results The positive expression of VEGF is significantly higher in TACE group （86.0%） than that in pure surgery group （65.0%） （P = 0.015）. MVD in TACE group was （79.37 ± 15.36）, which was significantly higher than that in pure surgery group （43.23 ± 14.98） （P = 0.000）. In TACE group, the positive expression level of VEGF had a parallel relationship with MVD （rs = 0.493, P 〈 0.01）. In Group B, MVD surrounding the lesion was （80.44± 13.74）, which was slightly higher than that in group A （78.08 ± 15.33）, but the difference was of no statistical significance （P 〉0.05）. Conclusion The theory that TACE can induce angiogenesis may not be the mechanism which causes the difference in the formation of collateral circulation between the anterior and the posterior segments of right hepatic lobe in patients with primary hepatocellular carcinoma after TACE. （J Intervent Radiol, 2012, 21： 469-472）

关 键 词：肝细胞癌 经导管动脉化疗栓塞 肝段 血管内皮生长因子 微血管密度 

分 类 号：R735.7[医药卫生—肿瘤]