Xiao En-Hua, Guo Dong, Bian Du-Jun
Department of Radiology, the Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.
World J Gastroenterol. 2009 Sep 28;15(36):4582-6. doi: 10.3748/wjg.15.4582.
To evaluate the effects of four types of preoperative transcatheter arterial chemoembolization (TACE) on angiogenesis of hepatocellular carcinoma (HCC) cells.
A total of 136 patients with HCC underwent liver resection. One to five courses of TACE prior to liver resection were performed in 79 patients (TACE group), in which one to four courses of chemotherapy alone were performed in 11 patients (group A); one to five courses of chemotherapy combined with iodized oil were performed in 33 patients (group B); one to three courses of chemotherapy combined with iodized oil and gelatin sponge were performed in 23 patients (group C); one to three courses of chemotherapy combined with iodized oil, ethanol and gelatin sponge were performed in 12 patients (group D). The other 57 patients only received liver resection (non-TACE group). The microvessels were marked by CD31. The expression of CD31 and vascular endothelial growth factor (VEGF) protein were detected by immunohistochemical methods.
The mean microvessel density (MVD) in HCC cells was significantly higher in groups A, B, C and D than in the non-TACE group (P < 0.05). The expression of VEGF protein in HCC cells were significantly higher in groups A, B, C and D than in the non-TACE group (P < 0.05). MVD and the expression of VEGF protein were positively correlated. Mean MVD and the expression of VEGF protein were closely related to the number of courses of TACE and the interval of TACE.
Four different types of preoperative TACE regimens enhanced angiogenesis in HCC cells by up-regulating the expression of VEGF protein. It is necessary to repress angiogenesis of liver cancer after TACE.
评估四种类型的术前经导管动脉化疗栓塞术(TACE)对肝细胞癌(HCC)细胞血管生成的影响。
136例HCC患者接受了肝切除术。79例患者在肝切除术前进行了1至5个疗程的TACE(TACE组),其中11例患者仅进行了1至4个疗程的单纯化疗(A组);33例患者进行了1至5个疗程的化疗联合碘化油(B组);23例患者进行了1至3个疗程的化疗联合碘化油和明胶海绵(C组);12例患者进行了1至3个疗程的化疗联合碘化油、乙醇和明胶海绵(D组)。另外57例患者仅接受了肝切除术(非TACE组)。微血管用CD31标记。采用免疫组织化学方法检测CD31和血管内皮生长因子(VEGF)蛋白的表达。
A、B、C、D组HCC细胞中的平均微血管密度(MVD)显著高于非TACE组(P<0.05)。A、B、C、D组HCC细胞中VEGF蛋白的表达显著高于非TACE组(P<0.05)。MVD与VEGF蛋白的表达呈正相关。平均MVD和VEGF蛋白的表达与TACE疗程数和TACE间隔密切相关。
四种不同类型的术前TACE方案通过上调VEGF蛋白的表达增强了HCC细胞的血管生成。TACE术后抑制肝癌血管生成是必要的。