Matsui Daigo, Nagai Hidenari, Mukozu Takanori, Ogino Y U, Sumino Yasukiyo
Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
Anticancer Res. 2015 Apr;35(4):2205-10.
Vascular endothelial growth factor (VEGF) is a primary driving force for both physiological and pathological angiogenesis and over-expression of VEGF has been detected in hepatocellular carcinoma (HCC). The aim of the present study was to clarify the usefulness of VEGF for monitoring the response to intra-arterial chemotherapy in patients with HCC.
Seventy-three patients with liver cirrhosis (LC) and advanced HCC (aHCC) received hepatic arterial infusion chemotherapy (HAIC: leucovorin (LV) at 12 mg/h, cisplatin (CDDP) at 10 mg/h and 5-fluorouracil (5-FU) at 250 mg/22 h) via the proper hepatic artery every 5 days for 4 weeks using a catheter connected to a subcutaneous drug delivery system.
i) Serum VEGF levels were higher in patients with progressive disease than those in patients with a partial response or stable disease. ii) VEGF levels were higher in patients with alcoholic LC than those in patients with hepatitis C-related or hepatitis B-related LC. iii) VEGF levels were higher in stage IVB patients than those in patients with stage III or IVA disease. iv) VEGF levels were significantly higher in patients with giant or confluent multinodular tumors than those in patients with multiple discrete nodules. v) Serum VEGF levels were higher in patients with vascular invasion than in patients without vascular invasion.
Monitoring the serum VEGF level is useful for predicting the response of aHCC to HAIC, as well as for predicting metastasis, tumor type and vascular invasion.
血管内皮生长因子(VEGF)是生理性和病理性血管生成的主要驱动力,且在肝细胞癌(HCC)中已检测到VEGF的过表达。本研究的目的是阐明VEGF在监测HCC患者动脉内化疗反应中的作用。
73例肝硬化(LC)合并晚期HCC(aHCC)患者通过连接皮下给药系统的导管,经肝固有动脉每5天接受一次肝动脉灌注化疗(HAIC:亚叶酸钙(LV)12mg/h、顺铂(CDDP)10mg/h和5-氟尿嘧啶(5-FU)250mg/22h),共4周。
i)疾病进展患者的血清VEGF水平高于部分缓解或病情稳定患者。ii)酒精性LC患者的VEGF水平高于丙型肝炎相关或乙型肝炎相关LC患者。iii)IVB期患者的VEGF水平高于III期或IVA期患者。iv)巨大或融合性多结节肿瘤患者的VEGF水平显著高于多个离散结节患者。v)有血管侵犯患者的血清VEGF水平高于无血管侵犯患者。
监测血清VEGF水平有助于预测aHCC对HAIC的反应,以及预测转移、肿瘤类型和血管侵犯。