Jia Zhong-zhi, Jiang Guo-min, Feng Yao-liang
Department of Interventional Radiography, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou 213003, China.
Chin Med Sci J. 2011 Sep;26(3):158-62. doi: 10.1016/s1001-9294(11)60041-2.
To investigate the expression levels of serum hypoxia inducible factor 1 alpha (HIF-1alpha) and vascular endothelial growth factor (VEGF) pre- and post-transcatheter arterial chemoembolization (TACE) in patients with primary liver cancer (PLC), and correlations between prognosis factors and serum HIF-1alpha as well asVEGF levels.
Forty consecutive patients fulfilling diagnostic criteria for PLC undergoing TACE from March 2008 to May 2009 were enrolled into the study. The serum HIF-1alpha and VEGF levels of PLC patients pre- and 1 day, 1 week, 1 month post-TACE were analyzed using ELISA, and compared with that of 20 healthy volunteers. Patients were divided into complete response (CR) and partial response (PR), stable disease (SD), progressive disease (PD) groups according to the therapeutic efficacy. Pearson correlation was used to analyze the correlation between different clinical variables and serum HIF- 1alpha and VEGF levels before TACE, and correlation between serum HIF-1alpha and VEGF levels was also evaluated.
The expression levels of serum HIF-1alpha and VEGF in PLC patients were 154.94 +/- 83.29 and 264.00 +/- 148.10 pg/mL pre-TACE, and both of them were significantly higher than those in control group (23.84 +/- 8.15 and 69.78 +/- 21.42 pg/mL, all P<0.01). One day after TACE, both serum HIF-1alpha (570.64 +/- 230.87 pg/mL) and VEGF levels (362.07 +/- 102.25 pg/mL) reached the peak values (all P<0.01). One week post-TACE, expression levels of them were decreased (198.62 +/- 92.11 and 283.52 +/- 145.46 pg/mL respectively), but still significantly higher than those before TACE (all P<0.01). The levels of both HIF-1alpha (133.96 +/- 57.02 vs. 255.74 +/- 123.44 pg/mL) and VEGF (150.96 +/- 84.89 vs. 368.95 +/- 161.90 pg/mL) in CR group 1 month post-TACE were significantly lower than those in PR+SD+PD group (all P<0.01). The level of serum HIF-1alpha was positively correlated with serum VEGF level (r=0.42, P<0.001). Both serum HIF-1alpha and VEGF levels were observed to be correlated with portal vein tumor thrombi (P<0.05) and metastasis (P<0.05).
The HIF- 1alpha and VEGF might play an important role in relapse of PLC. They might be considered as predictors of the efficacy ofTACE and metastasis of PLC.
探讨原发性肝癌（PLC）患者经动脉化疗栓塞术（TACE）前后血清缺氧诱导因子1α（HIF-1α）和血管内皮生长因子（VEGF）的表达水平，以及预后因素与血清HIF-1α和VEGF水平之间的相关性。
选取2008年3月至2009年5月期间连续40例符合PLC诊断标准并接受TACE治疗的患者纳入研究。采用酶联免疫吸附测定法（ELISA）分析PLC患者TACE术前、术后1天、1周、1个月的血清HIF-1α和VEGF水平，并与20名健康志愿者进行比较。根据治疗效果将患者分为完全缓解（CR）、部分缓解（PR）、疾病稳定（SD）、疾病进展（PD）组。采用Pearson相关性分析TACE术前不同临床变量与血清HIF-1α和VEGF水平之间的相关性，同时评估血清HIF-1α和VEGF水平之间的相关性。
PLC患者TACE术前血清HIF-1α和VEGF表达水平分别为154.94±83.29和264.00±148.10 pg/mL，均显著高于对照组（23.84±8.15和69.78±21.42 pg/mL，均P<0.01）。TACE术后1天，血清HIF-1α（570.64±230.87 pg/mL）和VEGF水平（362.07±102.25 pg/mL）均达到峰值（均P<0.01）。TACE术后1周，二者表达水平下降（分别为198.62±92.11和283.52±145.46 pg/mL），但仍显著高于TACE术前（均P<0.01）。CR组TACE术后1个月HIF-1α（133.96±57.02 vs. 255.74±123.4 pg/mL）和VEGF（150.96±84.89 vs. 368.95±161.90 pg/mL）水平均显著低于PR+SD+PD组（均P<0.01）。血清HIF-1α水平与血清VEGF水平呈正相关（r=0.42，P<0.001）。血清HIF-1α和VEGF水平均与门静脉癌栓（P<0.05）和转移（P<0.05）相关。
HIF-1α和VEGF可能在PLC复发中起重要作用。它们可能被视为TACE疗效和PLC转移的预测指标。
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