血管内皮生长因子评价伽玛刀治疗肝癌的疗效
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摘要
目的分析血管内皮生长因子(VEGF)水平与伽玛刀治疗原发性肝癌(PCL)疗效的关系,探讨其临床意义。方法检测19例PCL伽玛刀治疗前和治疗1个月后血清VEGF水平,分析其与疗效、患者生存期及生活质量的关系。结果PCL患者伽玛刀治疗前血清VEGF水平(927. 2±278. 1) pg/ml,治疗后1个月为(287. 1±148. 8) pg/ml,差异有统计学意义(P <0. 001)。血清VEGF含量下降≥65%的15例中,CR+PR14例,生活质量改善4例;血清VEGF含量下降<65%的4例中,CR+PR1例,生活质量改善1例,2组差异有统计学意义(P=0. 024,P=0. 013)。随访满2年17例患者血清VEGF下降≥65%的14例中,1年生存率92. 9%(13/14),显著高于血清VEGF下降<65%者(0/3),差异有统计学意义(P=0. 006)。结论伽玛刀治疗后PCL患者血清VEGF水平下降,其下降幅度可作为评价疗效的指标。
Objective To analyze the relationship between the level of vascular endothelial growth factor( VEGF) and therapeutic efficacy of gamma rays in the treatment of primary carcinoma of liver( PCL),and also to investigate its clinical significance.Methods The serum VEGF levels of 19 patients with PCL treated with gamma rays were assayed before and one month after treatment. The relationship between therapeutic efficacy,survival time,life quality and serum VEGF level was analyzed in the study.Results The serum VEGF level of the 19 patients before treatment was( 927. 2 ± 278. 1) pg/ml,whereas its level dropped to( 287. 1± 148. 8) pg/ml one month after treatment,and statistical significance could be noted when comparisons were made between them( P < 0. 001). In the 15 patients whose serum VEGF level decreased by ≥65%,there were 14 patients with CR + PR and 4 patients whose life quality improved. In the 4 patients whose serum VEGF level decreased by < 65%,there were 1 patient with CR + PR and 1 patient whose life quality improved. Statistical significance could be noticed when comparisons were made between the groups( P =0. 024,P = 0. 013). Of 17 patients who completed 2-year medical follow-ups and whose serum VEGF level decreased by ≥65%,92. 9%( 13 of 14) of the patients had one-year survival,which was significantly higher than that of the patients whose serum VEGF level dropped by < 65%( 0/3,P = 0. 006). Conclusion Following treatment by gamma rays,the serum VEGF level of the patients with PCL reduced,and the rate of reduction could be used as an index for the evaluation of therapeutic efficacy.
Objective To analyze the relationship between the level of vascular endothelial growth factor( VEGF) and therapeutic efficacy of gamma rays in the treatment of primary carcinoma of liver( PCL),and also to investigate its clinical significance.Methods The serum VEGF levels of 19 patients with PCL treated with gamma rays were assayed before and one month after treatment. The relationship between therapeutic efficacy,survival time,life quality and serum VEGF level was analyzed in the study.Results The serum VEGF level of the 19 patients before treatment was( 927. 2 ± 278. 1) pg/ml,whereas its level dropped to( 287. 1± 148. 8) pg/ml one month after treatment,and statistical significance could be noted when comparisons were made between them( P < 0. 001). In the 15 patients whose serum VEGF level decreased by ≥65%,there were 14 patients with CR + PR and 4 patients whose life quality improved. In the 4 patients whose serum VEGF level decreased by < 65%,there were 1 patient with CR + PR and 1 patient whose life quality improved. Statistical significance could be noticed when comparisons were made between the groups( P =0. 024,P = 0. 013). Of 17 patients who completed 2-year medical follow-ups and whose serum VEGF level decreased by ≥65%,92. 9%( 13 of 14) of the patients had one-year survival,which was significantly higher than that of the patients whose serum VEGF level dropped by < 65%( 0/3,P = 0. 006). Conclusion Following treatment by gamma rays,the serum VEGF level of the patients with PCL reduced,and the rate of reduction could be used as an index for the evaluation of therapeutic efficacy.
引文
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[8] Tsuzuki Y,Mouta Carreira C,Bockhorn M,et al. Pancreas microenvironment promotes VEGF expression and tumor growth:novel window models for pancreatic tumor microcirculation[J]. Lab Invest,2001,81:1439-1451.
[9]王其春,李国平.血管内皮生长因子在肝细胞癌及慢性肝病检测中的应用[J].医学检验与临床,2008,19(3):36-38. DOI:10. 3969/j. issn. 1673-5013. 2008. 03. 013.
[10] Jinno K,Tanimizu M,Hyodo I,et al. Circulation vascular endothelial growthfactor(VEGF)is a predictor of invasion and metastasis in hepatocellular carcinoma[J]. J Gastroenterology,1998,33:376-382.
[11] Yamamoto H,Itob F,Adachi Y,et al. Relation of enhanced secretion of active matrix metalloproteinase with tumor spread in human hepatocellular carcinoma[J]. Gastroenterology,1997,112(23),1290-1295.
[12]王修身,刘孟忠,张昌卿,等.同期放化疗对食管癌患者血管内皮生长因子表达水平的影响——附43例临床资料分析[J].癌症,2006,25:1428-1432. DOI:10. 3969/j. issn. 1000-467X.2006. 11. 021.
[2]康静波,聂青,张丽萍,等.立体定向放射(体部伽玛刀)治疗原发性肝癌的疗效分析[J].海军总医院学报,2005,18(1):16-19. DOI:10. 3969/j. issn. 1009-3427. 2005. 01. 005.
[3] Yamamoto H,Itob F,Adachi Y,et al. Relation of enhanced secretion of active matrix metalloproteinase with tumor spread in human hepatocellular carcinoma[J]. Gastroenterology,1997,112(23),1290-1295.
[4]克尤木·阿不来提,周应恩,布瓦扎尔·沙吾提.鸦胆子油乳剂辅助经导管肝动脉化疗栓塞术治疗肝癌患者临床疗效及对血浆内毒素、血管内皮生长因子水平影响[J].临床军医杂志,2017,45(8):851-856. DOI:10. 16680/j. 1671-3826. 2017. 08.24.
[5]冯众一,高鹏,谭文翔,等.原发性肝癌TACE介入治疗前后血清VEGF和bFGF水平变化及临床意义[J].中国现代普通外科进展,2015,18(2):154-158. DOI:10. 3969/j. issn. 1009-9905. 2015. 02. 022.
[6]李淑敏,范建.重组人血管内皮抑制素联合肝动脉化疗栓塞治疗中晚期肝癌疗效及对MIF和VEGF水平的影响[J].现代中西医结合杂志,2016,25(15):1655-1657. DOI:10. 3969/j.issn. 1008-8849. 2016. 15. 020.
[7]周际昌.实用肿瘤内科治疗[M].北京:科学技术出版社,2016:538-540.
[8] Tsuzuki Y,Mouta Carreira C,Bockhorn M,et al. Pancreas microenvironment promotes VEGF expression and tumor growth:novel window models for pancreatic tumor microcirculation[J]. Lab Invest,2001,81:1439-1451.
[9]王其春,李国平.血管内皮生长因子在肝细胞癌及慢性肝病检测中的应用[J].医学检验与临床,2008,19(3):36-38. DOI:10. 3969/j. issn. 1673-5013. 2008. 03. 013.
[10] Jinno K,Tanimizu M,Hyodo I,et al. Circulation vascular endothelial growthfactor(VEGF)is a predictor of invasion and metastasis in hepatocellular carcinoma[J]. J Gastroenterology,1998,33:376-382.
[11] Yamamoto H,Itob F,Adachi Y,et al. Relation of enhanced secretion of active matrix metalloproteinase with tumor spread in human hepatocellular carcinoma[J]. Gastroenterology,1997,112(23),1290-1295.
[12]王修身,刘孟忠,张昌卿,等.同期放化疗对食管癌患者血管内皮生长因子表达水平的影响——附43例临床资料分析[J].癌症,2006,25:1428-1432. DOI:10. 3969/j. issn. 1000-467X.2006. 11. 021.