中晚期原发性肝癌患者TACE术后VEGFR表达水平与疗效的相关性分析  

Correlation between VEGFR expression level and therapeutic effect of TACE therapy in patients with advanced primary liver cancer

作　　者：尹晓东[1] 后博 李海洋 张明雷[1] YIN Xiao-dong;HOU Bo;LI Hai-yang;ZHANG Ming-lei(Department of Oncology,Binhai County People's Hospital,Jiangsu 224500,China)

机构地区：[1]江苏省滨海县人民医院肿瘤科,224500

出　　处：《肝脏》2021年第10期1107-1111,共5页Chinese Hepatology

基　　金：盐城市医学科技发展项目(YK2015065)。

摘　　要：目的观察中晚期原发性肝癌患者经导管动脉化疗栓塞(TACE)术后疗效与血清VEGFR-2、VEGFR-3的关系。方法选择2017年1月至2019年1月滨海县人民医院收治的70例接受TACE治疗的中晚期原发性肝癌患者,检测TACE术前1天、术后7 d患者血清VEGFR-2、VEGFR-3表达水平,观察VEGFR-2、VEGFR-3与近期疗效、总生存期(OS)关系。结果疾病缓解患者△VEGFR-2降低率[59.52%(25/42)]及△VEGFR-3降低率[57.14%(24/42)]高于未缓解患者[32.14%(9/28)、33.33%(12/28),均P<0.05]。△VEGFR-2未降低患者Child-Pugh B级[77.8%(28/36)]、肝硬化[55.6%(20/36)]、肿瘤最大径[(4.69±1.58)cm]、AFP[489.8(452.9)μg/mL]、VEGF[(335.7±55.8)pg/mL]均高于△VEGFR-2降低患者[47.1%(16/34)、26.5%(9/34)、(3.89±1.46)cm、428.6(389.5)μg/mL、(248.9±46.9)pg/mL,均P<0.05];△VEGFR-3未降低患者Child-Pugh B级[85.3%(29/34)]、肝硬化[55.9%(19/34)]、肿瘤最大径[(4.71±1.67)cm]、AFP[488.6(462.0)μg/mL]、VEGF[(322.9±56.1)pg/mL]均高于△VEGFR-3降低患者[41.7%(15/36)、27.8%(10/36)、(3.91±1.39)cm、431.5(391.2)μg/mL、(253.6±51.0)pg/mL,均P<0.05]。随访时间15~34个月,失访6例。Kaplan-Meier法并Log-rank检验显示,△VEGFR-2降低患者的累积OS高于未降低患者(均P<0.05);△VEGFR-3降低患者的累积OS高于未降低患者(P<0.05)。ROC曲线分析结果显示,△VEGFR-3联合△VEGFR-2对原发性肝癌生存情况具有较高预测价值(AUC=0.84,P<0.01,95%CI=0.77~0.94),特异度为72.3%,灵敏度为86.9%。结论中晚期原发性肝癌患者TACE手术前后VEGFR-2、VEGFR-3变化水平与预后相关,△VEGFR-2联合△VEGFR-3可用于预测患者生存情况,外周血中VEGFR-2、VEGFR-3水平可能成为中晚期原发性肝癌预后标志物。Objective To investigate the relationship between serum vascular endothelial growth factor receptor 2(VEGFR-2),vascular endothelial growth factor receptor 3(VEGFR-3)and curative effect in patients with advanced primary liver cancer of transcatheter arterial chemoembolization(TACE)therapy.Methods Seventy patients with advanced primary liver cancer who received TACE therapy from January 2017 to January 2019 in our hospital were selected.The serum VEGFR-2,VEGFR-3 expression levels of patients were detected 1 day before TACE and 7 days after TACE therapy,The relationship among VEGFR-2,VEGFR-3 and short-term efficacy,overall survival(OS)were analyzed.Results The reduction rates of VEGFR-2(59.52%)and VEGFR-3(57.14%)in patients with remission were higher than those in patients without remission(32.14%,57.14%,P<0.05).The rate of Child-Pugh B(77.8%),the rate of liver cirrhosis(55.6%),the tumor maximum diameter(4.69±1.58)cm,the serum alpha fetoprotein(AFP)level[489.8(452.9)μg/mL],and vascular endothelial growth factor(VEGF)level[(335.7±55.8)pg/mL]of patients whose serum VEGFR-2 levels did not reduce were higher,compared with those of the patients whose serum VEGFR-2 levels reduced[47.1%,26.5%,(3.89±1.46)cm,428.6(389.5)μg/mL,(248.9±46.9)pg/ml,the differences were statistically significant,P<0.05].The rate of Child-Pugh B(85.3%),the rate of liver cirrhosis(55.9%),the tumor maximum diameter[(4.71±1.67)cm],the serum AFP level[488.6(462.0)μg/mL]and VEGF level[(322.9±56.1)pg/mL]of patients whose serum VEGFR-3 levels did not reduce were higher,compared with those of the patients whose serum VEGFR-3 levels reduced(41.7%,27.8%,(3.91±1.39)cm,431.5(391.2)μg/mL,(253.6±51.0)pg/mL,the differences were statistically significant,P<0.05).Patients were followed up from 15 to 34 months(23.9±3.8 months on average),but 6 cases were lost.Kaplan-Meier method and Log-rank test showed that patients with reduced VEGFR-2 or VEGFR-3 had a higher cumulative OS rate than those without reduction(the differences were statistically significan

关 键 词：中晚期原发性肝癌 经导管动脉化疗栓塞 预后 血管内皮生长因子 血管内皮生长因子受体 

分 类 号：R73[医药卫生—肿瘤]