伽马刀治疗肝癌的近期疗效及血清HIF-1α,VEGF的动态变化  

Short-Term Effect of Gamma-Knife Treatment on Hepatocellular Carcinoma and Changes of HIF-1 Alpha and VEGF

作　　者：梅芬[1] 金超超[2] 方士强[1] 孔德勇[1] 卢忠心[1] 

机构地区：[1]武汉市中心医院检验科,湖北武汉430014 [2]湖北省黄石市中心医院普爱病区肿瘤科,湖北黄石435000

出　　处：《武汉大学学报（医学版）》2015年第4期568-570,599,共4页Medical Journal of Wuhan University

摘　　要：目的:观察伽马刀治疗原发性肝癌的近期疗效及患者血清低氧诱导因子(HIF-1α)、血管内皮生长因子(VEGF)的动态变化。方法:选取在本院应用伽玛刀治疗的22例原发性肝癌患者(PHC)为研究对象,并将同期在我院体检的健康人群20例纳入对照组,观察PHC组放疗前后血清VEGF、HIF-1α水平的动态变化,以完全缓解、部分缓解视为有效,无变化、进展为无效,分析VEGF、HIF-1α水平与疗效的关系。结果:PHC组放疗前、放疗结束后1d、放疗结束后1个月的血清VEGF、HIF-1α水平显著高于对照组(P<0.05);动态观察放疗期间PHC组上述血清学变化,放疗结束后1d血清VEGF、HIF-1α显著高于放疗前及放疗结束后1个月(P<0.05)。放疗后随访6个月,22例患者完全缓解(CR)1例,部分缓解(PR)13例,无变化(NC)4例,进展(PD)4例。不同疗效患者放疗结束后1d血清VEGF、HIF-1α无明显差异,而放疗结束后1个月,NC+PD患者血清VEGF、HIF-1α显著高于CR+PR患者(P<0.05)。结论:伽玛刀可有效控制肝癌进展,治疗期间PHC患者血清VEGF、HIF-1α水平常呈一过性升高,动态检测VEGF、HIF-1α可评估近期疗效。Objective. To observe the curative effect of 7-knife treatment on primary hepatocellular car- cinoma （PHC） and the changes of HIF-1α and VEGF. Methods. Twenty-two patients with hepa- tocellular carcinoma who had undergone 7-knife treatment in our hospital were selected as PHC group in this study, while 20 healthy people were chosen as control group. The dynamic changes of HIF-1αand VEGF were observed before and after treatment. Complete remission（CR） or par- tial remission（PR） was taken as valid and no change（NC）, progressive disease（PD） as invalid. The relationship of the curative effect with HIF-1α and VEGF was analyzed. Results. On the 1st day and the 1st month after radiotherapy, the level of serum HIF-1α and VEGF in PHC group were all higher than those in the control group（P〈0.05）. In the PHC group, the level of HIF-laand VEGF on the 1st day after radiotherapy were higher than those before radiotherapy and one month after radiotherapy（P〈0.05）. All patients were followed up for 6 months, 1 patient had CR, 13 had PR, 4 had NC and 4 had PD. There were no obvious differences in the level of HIF-1α and VEGF between the CR＋PR and the NC＋PD on the 1st day after radiotherapy. But the level of HIF-1α and VEGF in the NC＋PD patients were higher than the CR＋PR. Conclusion. Gamma-knife radiotherapy had high efficacy, and the level of serum HIF-1α and VEGF would in- crease temporarily. Dynamic observation of the serum HIF-1α,VEGF can assess the prognosis.

关 键 词：伽马刀 肝癌 低氧诱导因子 血管内皮生长因子 

分 类 号：R735.7[医药卫生—肿瘤]