Leelawat Kawin, Laisupasin Pikul, Kiatdilokrut Alongkorn, Pongtongpool Tavutchai, Narong Siriluk, Samkhumphim Nongluk, Ket-Horm Sukit
Department of Surgery, Rajavithi Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2008 Oct;91(10):1539-43.
Treatment of hepatocellular carcinoma (HCC) with transcatheter arterial chemoembolization (TACE) is known to induce vascular endothelial growth factor (VEGF) expression. A recent study has shown that doxorubicin can repress hypoxic induction of VEGF expression in human cancer cells.
To evaluate the combination effects of doxorubicin and TACE on the change of serum VEGF after TACE.
Thirty patients with unresectable HCC were assigned into two groups, the experiment group (n = 15) received TACE with doxorubicin (25-50 mg) plus mitomycin C (5-10 mg), and the control group (n = 15) received TACE with mitomycin C (5-10 mg). Serum VEGF before and after TACE (24 hour) was measured by quantitative sandwich enzyme-linked immunosorbent assay.
Baseline serum VEGF was correlated with the size of tumor (r2 = 0.85; p = 0.03). In addition, serum VEGF was significantly elevated after TACE (p = 0.014). However; the change of serum VEGF after TACE is not statistically different in both groups (p = 0.72). At 2-years, the overall survival was 38% and 40% in the experiment and control group, respectively (p = 0.48).
The present study suggests that doxorubicin improves neither the level of serum VEGF nor the survival in HCC patients treated with TACE.
经导管动脉化疗栓塞术（TACE）治疗肝细胞癌（HCC）可诱导血管内皮生长因子（VEGF）表达。最近一项研究表明，阿霉素可抑制人癌细胞中VEGF表达的低氧诱导。
评估阿霉素与TACE联合应用对TACE后血清VEGF变化的影响。
30例无法切除的HCC患者被分为两组，实验组（n = 15）接受TACE联合阿霉素（25 - 50 mg）及丝裂霉素C（5 - 10 mg），对照组（n = 15）接受TACE联合丝裂霉素C（5 - 10 mg）。采用定量夹心酶联免疫吸附测定法检测TACE前及TACE后（24小时）血清VEGF水平。
基线血清VEGF与肿瘤大小相关（r2 = 0.85；p = 0.03）。此外，TACE后血清VEGF显著升高（p = 0.014）。然而，两组TACE后血清VEGF的变化无统计学差异（p = 0.72）。2年时，实验组和对照组的总生存率分别为38%和40%（p = 0.48）。
本研究提示，阿霉素既不能改善接受TACE治疗的HCC患者的血清VEGF水平，也不能提高其生存率。
