肝细胞癌患者TACE治疗后血浆胎盘生长因子含量变化及预后意义  

Changes and prognosis significance of plasma placental growth factor in hepatocellular carcinoma patients after TACE

作　　者：孟庆雯[1] 李勇[1] 胡宝山[1] 邵培坚[1] 占美晓[1] 禹娴怡[1] 陆骊工[1] 

机构地区：[1]广东省医学科学院广东省人民医院肿瘤中心介入治疗科,广东广州510080

出　　处：《中国介入影像与治疗学》2013年第5期279-282,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：广东省科技计划项目基金(2011A030400009)

摘　　要：目的探讨原发性肝细胞癌(HCC)患者TACE前后血浆胎盘生长因子(PLGF)含量变化及其评估预后的价值。方法采用ELISA法检测43例HCC患者TACE术前1～3天及术后第1、3、7天及1个月血浆PLGF含量,同期检测25例肝硬化患者及25名健康成年人的血浆PLGF含量,分析TACE前后血浆PLGF含量变化及其预后价值。结果 HCC患者血浆PLGF含量明显高于健康成年人及肝硬化患者(P均<0.001)。血浆PLGF含量在巴塞罗纳临床肝癌(BCLC)分期(P=0.031)、肿瘤大小(P=0.009)、门静脉癌栓(P=0.007)、有无转移(P=0.046)方面有差异;TACE术后第1天血浆PLGF含量明显升高,第3、7天、1个月降低,但仍高于术前(P均<0.05)。按术前血浆PLGF含量再分为含量高组(≥641.04pg/ml)与含量低组(<641.04pg/ml),含量低组总生存时间长于含量高组(P=0.021)。Cox回归分析显示,肿瘤大小及术前血浆PLGF含量是影响HCC患者预后的独立因素(P=0.021、0.023)。结论HCC患者TACE术后血浆PLGF水平较术前明显升高,术前血浆PLGF含量可以预测HCC患者的预后。Objective To investigate the changes of plasma placenta growth factor （PLGF） and the prognostic signifi- cance in patients with hepatocellular carcinoma （HCC） undergoing TACE. Methods Blood was collected 1--3 days before and 1, 3, 7 days and 1 month after TACE from 43 patients with HCC. Plasma PLGF levels were measured by ELISA. And the plasma PLGF of 25 patients with liver cirrhosis and 25 healthy adults were measured at the same time. The chan- ges and prognosis significance of plasma PLGF level were analyzed. Results Plasma PLGF levels of HCC patients were significantly higher than that of liver cirrhosis patients and normal controls （both P〈0. 001）. Significant differences of plasma PLGF level of HCC patients were observed in BCLC stage （P=0. 031）, tumor size （P：0. 009）, portal vein tumor thrombus （P=0. 007） and metastasis （P=0. 046）. The plasma PLGF levels increased significantly on the first day after TACE, and then decreased gradually but still higher than that in pre-operation （all P〈0.05）. Taking plasma PLGF level （641.04 pg/ml） as the cut-off level, patients with low plasma PLGF level （〈641.04 pg/ml） had better overall survival compared with those with high plasma PLGF level （≥641.04 pg/ml, P=0. 021）. In multivariate Cox analysis, tumor size and pre-treatment plasma PLGF level were independent and significant prognostic factors of survival of HCC patients after TACE （P=0. 021, 0. 023）. Conclusion Post-treatment plasma PLGF level is obviously higher than pre-treatment in HCC patients underwent TACE. Pre-treatment plasma PLGF level may predict poor prognosis after TACE in HCC patients.

关 键 词：肝肿瘤 胎盘生长因子 化学栓塞 治疗性 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]