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目的:观察巴塞罗那临床肝癌分期及治疗策略(Barcelona Clinic Liver Cancer Staging,BCLC)B期肝癌患者经动脉化疗栓塞术(transarterial chemoembolization,TACE)前后血管内皮生长因子(VEGF)表达水平的变化规律,探讨其可能的临床意义。方法:17例BCLC B期肝癌患者行TACE治疗。收集患者TACE术前1d及术后1、3、5、7、14、30d时外周静脉血,检测血VEGF表达水平,分析VEGF表达变化与肝癌生物学特性的关系。结果:与TACE术前1d相比,术后1d血VEGF有所升高,术后3、5d有所下降,术后14d较前均明显升高,差异有统计学意义(P<0.05)。存在肝动脉-门静脉瘘、随访CT/MRI发现明显新发病灶患者血VEGF水平较高。17例患者中疗效较好10例,疗效较差7例;两组间VEGF变化在术后14d差异有统计学意义(P<0.05)。结论:血浆VEGF表达水平可作为BCLC B期患者TACE治疗潜在的疗效评估指标。
OBJECTIVE: To observe the changes of vascular endothelial growth factor (VEGF) expression in patients with stage B hepatocellular carcinoma before and after transarterial chemoembolization (TACE) in Barcelona Clinic Liver Cancer Staging (BCLC) Possible clinical significance. Methods: Seventeen patients with BCLC stage B liver cancer underwent TACE. Peripheral venous blood samples were collected at 1 d before operation and at 1, 3, 5, 7, 14 and 30 days after TACE, and the relationship between VEGF expression and the biological characteristics of hepatocellular carcinoma was analyzed. Results: Compared with the first day before TACE, the level of blood VEGF increased on the 1st day after operation, and decreased on the 3rd and 5th day after operation. The level of VEGF was significantly increased on the 14th day after operation (P <0.05). The presence of hepatic artery - portal vein fistula, follow-up CT / MRI found significant new lesions in patients with high blood levels of VEGF. Seventeen patients had better curative effect in 10 patients and poor curative effect in 7 patients. There was significant difference in VEGF between the two groups on the 14th postoperative day (P <0.05). Conclusion: The expression of VEGF in plasma can be used as a potential therapeutic indicator for TACE in patients with BCLC stage B.