原发性肝癌TACE前后血清HIF-1α、VEGF与CT灌注成像的相关性分析  

Correlations between serum hypoxia inducible factor-1α, vascular endothelial growth factor and computed tomography perfusion imaging at pre- and post-TACE in patients with primary hepatic carcinoma

作　　者：贾中芝[1] 黄渊全[2] 冯耀良[3] 蒋国民[1] 

机构地区：[1]南京医科大学附属常州第二人民医院介入与血管外科,江苏省常州市213003 [2]苏州大学附属三院放射科 [3]南京医科大学第一附属医院介入放射科

出　　处：《中华医学杂志》2013年第19期1472-1475,共4页National Medical Journal of China

摘　　要：目的探讨原发性肝癌（HCC）经导管动脉化疗栓塞（TACE）术前后血清缺氧诱导因子1α（HIF-1α）及血管内皮生长因子（VEGF）与肿瘤组织CT灌注参数的相关性。方法对2008年3月至2010年7月南京医科大学附属常州第二人民医院介入与血管外科22例HCC患者TACE术前1d，术后32～40d行血清HIF-1α及VEGF检测及CT灌注成像（CTPI），得到血清HIF—1α、VEGF、肿瘤组织肝动脉灌注量（HAP）、门静脉灌注量（PVP）及肝动脉灌注指数（HPI）等参数值，并进行统计学分析。结果根据TACE术后32～40d疗效分为：稳定组和肿瘤残存或复发组。术前两组血清HIF-1α（μg/L）、VEGF（μg/L）及HAP[ml·min^-1·（100ml）^-1]、PVP[m1-min^-1·（100m1）^-1]、HPI差异均无统计学意义，而术后差异均有统计学意义[稳定组比复发组：124±60比258±113，144±94比354±137，0比33±11，0比21±12，0比61±10]；术后32～40d：稳定组血清HIF—1α、VEGF较术前明显降低，血清VEGF差异有统计学意义（均P〈0．05），肿瘤组织未检测到HAP、PVP灌注信号；而肿瘤残存或复发组血清HIF-1d、VEGF较术前均增高，差异均有统计学意义（均P〈0．05），肿瘤组织HAP、HPI较术前明显降低，差异均有统计学意义（均P〈0．05），PVP无明显变化。术后32～40d血清HIF-1d、VEGF与肿瘤组织HAP、HPI呈正相关。结论血清HIF-1α、VEGF能够间接反映TACE术后肿瘤组织微血管生成情况；CTPI能直观和定量地反映TACE术后肿瘤组织的血流动力学变化。故联合应用血清HIF-1α、VEGF及CTPI有助于TACE术后疗效的评价，对明确再次TACE治疗的时间及治疗方案的确定具有重要临床价值。Objective To explore the correlations between the serum levels of hypoxia inducible factor-1α （ HIF-1α） , vascular endothelial growth factor （VEGF） and computed tomography （CT） perfusion parameters at pre- and post-transcatheter arterial chemoembolization （TACE） in patients with primary hepatic carcinoma （PHC）. Methods A total of 22 PHC patients were recruited. Their serum levels of HIF-1α and VEGF were measured and CT perfusion imaging （CTPI） was performed at Day ! pre- and Days 32 - 40 post-TACE to compare and analyze the relevance of the changes of serum levels of HIF-1α, VEGF,tumor＇s hepatic artery peffusion （HAP）, portal vein perfusion （PVP） and hepatic artery perfusion index （HPI） at pre- and post-TACE. Results They were divided into stable and tumor residual/recurrent groups according to the efficacy of TACE. No significant differences existed between two groups with respects to serum levels of HIF-1α, VEGF, tumor＇s HAP, PVP and HPI pre-TACE. The serum levels of HIF-1α and VEGF decreased in stable group and there was significant difference in serum level of VEGF at Days 32 - 40 post-TACE （ P 〈 0. 05 ）. There was no perfusion signal of HAP or PVP in tumor tissue. The serum levels of HIF-1α and VEGF were significantly higher while HAP and HPI were significantly lower than that pre-TACE in tumor residual/recurrent group and had statistical significance （P 〈 0.05 ）, but PYP had no change. Positive correlations existed between serum levels of HIF-1α, VEGF and tumor＇s HAP, HPI at 32 -40 days post-TACE. Conclusion Serum levels of HIF-1α and VEGF may indirectly reflect the status of neovascularization and CTPI acts as the intuitive and quantitative responses of hemodynamic changes at postTACE. Positive correlations exist between serum levels of HIF-1α, VEGF, HAP and HPI. In short, a combination of serum levels of HIF-1α, VEGF and CTPI contributes to the efficacy evaluation of TACE and has great reference significance of determining timing of a second

关 键 词：肝肿瘤 缺氧诱导因子1 Α亚基 血管内皮生长因子类 

分 类 号：R735[医药卫生—肿瘤]