血管内皮生长因子、碱性成纤维细胞生长因子和血管生成素在可切除肝细胞癌患者术后的预后意义

Prognostic significance of vascular endothelial growth factor, basic fibroblast growth factor, and angiogenin in patients with resectable hepatocellular carcinoma after surgery.

作者信息

Chao Yee, Li Chung-Ping, Chau Gar-Yang, Chen Chih-Ping, King Kuang-Liang, Lui Wing-Yiu, Yen Sang-Hue, Chang Full-Young, Chan Wing-Kai, Lee Shou-Dong

机构信息

Cancer Center, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

Ann Surg Oncol. 2003 May;10(4):355-62. doi: 10.1245/aso.2003.10.002.

DOI:10.1245/aso.2003.10.002

PMID:12734082

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) is a hypervascular malignancy. Vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and angiogenin (ANG) are important angiogenic factors of neoangiogenesis. This study investigated the predictive value of serum VEGF, bFGF, and ANG in tumor recurrence, disease-free survival (DFS), and overall survival (OS) in HCC patients.

METHODS

Preoperative serum VEGF, bFGF, and ANG were measured in 98 patients with resectable HCC and in 15 healthy controls. The median follow-up time was 43 months.

RESULTS

Preoperative serum VEGF was increased in patients with resectable HCC compared with healthy controls (P <.05). Increased serum VEGF was correlated with tumor recurrence (P =.001). Univariate analysis showed that serum VEGF, tumor-node-metastasis stage, tumor size and number, macroscopic portal vein invasion, and microscopic vascular invasion were correlated with OS and DFS. Serum bFGF and ANG were not associated with survival. Multivariate analysis showed that serum VEGF was the most significant predictor of DFS (relative risk, 2.35; 95% confidence interval, 1.26-4.39; P =.007) and OS (relative risk, 3.44; 95% confidence interval, 1.81-6.57; P <.001) in HCC patients after surgical resection.

CONCLUSIONS

Preoperative serum VEGF is a significant independent predictor of tumor recurrence, DFS, and OS in patients with resectable HCC.

摘要

背景

肝细胞癌（HCC）是一种血管丰富的恶性肿瘤。血管内皮生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）和血管生成素（ANG）是新生血管形成的重要血管生成因子。本研究探讨血清VEGF、bFGF和ANG对HCC患者肿瘤复发、无病生存期（DFS）和总生存期（OS）的预测价值。

方法

检测98例可切除HCC患者及15例健康对照者术前血清VEGF、bFGF和ANG水平。中位随访时间为43个月。

结果

与健康对照相比，可切除HCC患者术前血清VEGF升高（P<.05）。血清VEGF升高与肿瘤复发相关（P =.001）。单因素分析显示，血清VEGF、肿瘤-淋巴结-转移分期、肿瘤大小和数量、肉眼门静脉侵犯及镜下血管侵犯与OS和DFS相关。血清bFGF和ANG与生存期无关。多因素分析显示，血清VEGF是HCC患者手术切除后DFS（相对风险，2.35；95%置信区间，1.26 - 4.39；P =.007）和OS（相对风险，3.44；95%置信区间，1.81 - 6.57；P<.001）的最显著预测因素。