TACE联合索拉菲尼治疗晚期肝癌患者的疗效及对血清VEGF、CTGF、HIF-1α及OPN水平的影响
The dynamic changes of serum VEGF, CTGF, HIF-1 and OPN levels in patients with advanced liver cancer treated with Sola Feeney combined with TACE
胡哲 1王培恩 1瞿海江1
作者信息
- 1. 台州市肿瘤医院 肿瘤外科,浙江 台州 317502
- 折叠
摘要
目的 探讨经肝动脉灌注化疗栓塞术(transcatheter arterial chemoembolization,TACE)联合索拉菲尼对晚期肝癌(hepatocellular carcinoma,HCC)患者的临床疗效及对血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、结缔组织生长因子(connective tissue growth factor,CTGF)、缺氧诱导因子1α(hypoxia inducible factor 1α,HIF-1α)及骨桥蛋白(osteopontin,OPN)水平的影响.方法 选取2013年9月～2014年12月台州市肿瘤医院收治的HCC 患者113 例,按照随机数字法分为对照组(n =56)和试验组(n =57),对照组采用TACE 治疗,试验组采用TACE 联合索拉菲尼治疗.分别于术前及术后1、3、7 d 采用间接酶联免疫吸附测定法检测并比较2 组患者血清VEGF、CTGF、HIF-1α及OPN 水平,并进行Spearman 相关性分析;统计2 组远期临床疗效及不良反应发生情况.结果 术后1 d 2 组患者血清VEGF、CTGF、HIF-1α及OPN 水平较术前显著升高( P< 0.01);术后1 d至7 d 2组患者血清各因子水平均呈下降趋势( P< 0.05),且2组间差异有统计学意义( P< 0.05);HIF-1α水平与VEGF、CTGF及OPN水平均呈显著正相关( r =0.951, r =0.954, r =0.929, P< 0.05);试验组中位生存时间及1年生存率较对照组显著增加( P< 0.01);试验组手足反应、脱发及腹泻发生率显著高于对照组( P< 0.05),2组间其他各项不良反应发生率差异无统计学意义.结论 TCAE联合索拉菲尼较单独TACE可显著降低HCC患者VEGF、CTGF、HIF-1α、OPN水平,延长患者生存期,且不增加不良反应.
Abstract
Objective To explore the clinical efficacy and the dynamic changes of serum vascular endothelial growth factor(VEGF),connective tissue growth factor(CTGF),hypoxia inducible factor 1α(HIF-1α)and osteopontin(OPN)levels after transcatheter arterial chemoembolization(TACE)combined with sorafenib in the treatment of advanced hepatocarcinoma(HCC)patients.Methods A total of 113 HCC patients in Cancer Hospital of Taizhou,from September 2013 to December 2014 were elected and were randomly divided into control group(n=56)and experiment group(n=57)according to random number.Control group were treated with sorafenib and experiment group were treated with TACE combined with sorafenib.The serum VEGF,CTGF,HIF-1α and OPN levels were tested and compared using indirect ELISA method preoperative and postoperative 1,3,7 days and which were carried out Spearman correlation analysis.The long-term clinical efficacy and adverse reaction in two groups were statisticed.Results The serum VEGF,CTGF,HIF-1α and OPN levels of two groups postoperative 1 day increased than preoperative(P<0.05).From postoperative one to seven days,the serum VEGF,CTGF,HIF-1α and OPN levels of two groups present downward trend(P<0.05 or P<0.01),and there was significant difference between two groups(P<0.01).The level of HIF-1α significantly positive correlated with the levels of VEGF,CTGF and OPN(r=0.951,0.954,0.929,P<0.05).Compared with control group,the median survival time and 1-year-survival rate of experiment group increased significantly(P<0.01).The incidence of hand-foot reaction,alopecia and diarrhea in experiment group were higher than those in control group(P<0.05),while the others had no significant difference between two groups(P>0.05).Conclusion The levels of VEGF,CTGF,HIF-1α and OPN of HCC patients after treated with TACE combined with sorafenib are lower than that treated with TACE alone,Simultaneously,the survival is prolonged and adverse reactions don't increase.
关键词
肝癌/索拉菲尼/肝动脉灌注化疗栓塞术/血管内皮生长因子/结缔组织生长因子/缺氧诱导因子1α/骨桥蛋白Key words
hepatocarcinoma/Sorafenib/transcatheter arterial chemoembolization/vascular endothelial growth factor/connective tissue growth factor/hypoxia inducible factor 1α/osteopontin引用本文复制引用
出版年
2017
NETL
NSTL
维普
万方数据