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目的探讨低氧诱导因子-1α(HIF-1α)在不同临床分期原发性肝癌治疗前后的变化及其临床意义。方法回顾性收集2013年5月至2015年5月期间笔者所在医院肝胆外科收治的80例原发性肝癌患者(原发性肝癌组)及同期接受体检的30位健康人群(对照组),原发性肝癌组分别于治疗前1 d、治疗后1周及治疗后1个月检测血清HIF-1α和甲胎蛋白(AFP)水平,对照组仅体检当日检测血清HIF-1α和AFP水平。比较2组患者的血清HIF-1α和AFP水平,并探索原发性肝癌患者治疗前后血清HIF-1α和AFP水平的动态变化规律。结果治疗前1 d、治疗后1周及治疗后1个月时,原发性肝癌组的HIF-1α和AFP水平均较对照组高,差异均有统计学意义(P<0.001)。原发性肝癌组HIF-1α和AFP水平3个时点间的两两比较差异均有统计学意义(P<0.050),均是治疗前1 d>治疗后1周>治疗后1个月。A、B及C期组的HIF-1α水平和AFP水平在治疗前1 d、治疗后1周及治疗后1个月均逐渐降低,同组内各时点间两两比较差异均有统计学意义(P<0.050)。治疗前1 d、治疗后1周及治疗后1个月时,A、B及C期组的HIF-1α水平和AFP水平均逐渐增高,同时点各分期组间两两比较差异均有统计学意义(P<0.050)。治疗前1 d、治疗后1周及治疗后1个月时,原发性肝癌患者的HIF-1α水平与AFP水平及临床分期均呈正相关(P<0.050)。结论治疗前后不同临床分期原发性肝癌患者血清HIF-1α水平的动态变化与AFP水平一致,HIF-1α有可能是评价原发性肝癌治疗效果的肿瘤标志物之一。
Objective To investigate the changes and their clinical significance of hypoxia inducible factor-1α (HIF-1α) before and after treatment in patients with primary liver cancer of different clinical stages. Methods Retrospectively collected 80 cases of primary liver cancer patients (primary liver cancer group) and 30 healthy subjects (control group) who underwent physical examination in the same period from May 2013 to May 2015 in our hospital. Serum levels of HIF-1α and AFP were measured at 1 d before treatment, 1 week after treatment and 1 month after treatment respectively. Serum HIF-1α and AFP levels were measured in the control group only on the day of physical examination. The levels of serum HIF-1α and AFP in two groups were compared, and the dynamic changes of serum HIF-1α and AFP in patients with primary liver cancer before and after treatment were explored. Results The levels of HIF-1α and AFP in primary hepatocellular carcinoma group were significantly higher than those in control group at 1 d before treatment, 1 week after treatment and 1 month after treatment. The difference was statistically significant (P <0.001). There were significant differences in HIF-1α and AFP levels between the three time points in primary liver cancer group (P <0.050), all of which were 1 d before treatment> 1 week after treatment> 1 month after treatment. The levels of HIF-1α and AFP in groups A, B and C decreased gradually 1 d before treatment, 1 week after treatment and 1 month after treatment, and there was statistical difference between every two groups Significance (P <0.050). At 1 d before treatment, 1 week after treatment and 1 month after treatment, the levels of HIF-1α and AFP in groups A, B and C were gradually increased, and the difference between the two groups was statistically significant Significance (P <0.050). At 1 d before treatment, 1 week after treatment and 1 month after treatment, the level of HIF-1α in patients with primary liver cancer was positively correlated with the level of AFP and the clinical stage (P <0.050). Conclusion The dynamic changes of serum HIF-1α levels in patients with primary liver cancer with different clinical stages before and after treatment are consistent with those of AFP. HIF-1α may be one of the tumor markers to evaluate the therapeutic effect of primary liver cancer.