Combination of vitamin K₂ and angiotensin-converting enzyme inhibitor ameliorates cumulative recurrence of hepatocellular carcinoma

详细信息    查看全文

• 作者：Hitoshi Yoshiji ; Ryuichi Noguchi ; Masahisa Toyohara ; Yasuhide Ikenaka ; Mitsuteru Kitade ; Kosuke Kaji ; Masaharu Yamazaki ; Junichi Yamao ; Akira Mitoro ; Masayoshi Sawai ; Motoyuki Yoshida ; Masao Fujimoto
• 关键词：Angiogenesis ; Angiotensin-converting enzyme inhibitor ; Hepatocellular carcinoma ; Vascular endothelial growth factor ; Vitamin K₂
• 刊名：Journal of Hepatology
• 出版年：2009
• 出版时间：August 2009
• 年：2009
• 卷：51
• 期：2
• 页码：315-321
• 全文大小：359 K

文摘

Background/Aims

No chemopreventive agent has been approved against hepatocellular carcinoma (HCC) yet. Since neovascularization plays a pivotal role in HCC, an angiostatic agent is considered as one of the promising approaches. The aim of this study was to elucidate the combined effect of the clinically used vitamin K₂ (VK) and angiotensin-converting enzyme inhibitor (ACE-I) on cumulative recurrence after curative treatment on a total of 87 patients, especially in consideration of neovascularization.

Methods

VK (menatetrenone; 45 mg/day) and/or ACE-I (perindopril; 4 mg/day) were administered for 36–48 months after curative therapy for HCC. The cumulative recurrence and several indices were analyzed.

Results

A 48-month follow-up revealed that the combination treatment with VK and ACE-I markedly inhibited the cumulative recurrence of HCC in association with suppression of the serum level of the vascular endothelial growth factor (VEGF); a central angiogenic factor. The serum level of lectin-reactive α-fetoprotein was also suppressed almost in parallel with VEGF. These beneficial effects were not observed with single treatment using VK or ACE-I.

Conclusions

The combination treatment of VK and ACE-I may suppress the cumulative recurrence of HCC after the curative therapy, at least partly through suppression of the VEGF-mediated neovascularization.