埃及患者丙型肝炎相关肝细胞癌中血管内皮生长因子的临床意义。
Clinical significance of vascular endothelial growth factor in hepatitis C related hepatocellular carcinoma in Egyptian patients.
机构信息
Department of Medicine, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Benha University, Benha, Egypt.
Department of Clinical Biochemistry, Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt.
出版信息
J Hepatocell Carcinoma. 2016 Jun 14;3:19-24. doi: 10.2147/JHC.S86708. eCollection 2016.
BACKGROUND AND AIMS
Several angiogenic factors are involved in the development and progression of hepatocellular carcinoma (HCC), a hypervascular tumor. Vascular endothelial growth factor (VEGF) is a primary driving force for angiogenesis, and its overexpression has been reported in HCC. However, the significance of plasma and tissue VEGF levels in HCC in Egyptian patients with chronic hepatitis C (CHC) infection is understudied. The aim of this study was to evaluate the role of VEGF (measured in plasma and liver tissue) in patients with hepatitis C virus-related HCC and to assess its significance in the diagnosis and prognosis of HCC.
MATERIALS AND METHODS
A total of 90 subjects were studied. Among 90 subjects, 60 with CHC were examined and were subdivided into two groups: 30 patients with CHC-related HCC (HCC group) and 30 patients with CHC without HCC (non-HCC group). Thirty apparently healthy subjects served as the control group. VEGF was estimated in plasma by enzyme-linked immunosorbent assay and its expression in liver tissue was evaluated by real-time polymerase chain reaction. VEGF expression level and its relationship to tumor parameters, patients' liver function profile, and patients' clinical parameters were also investigated.
RESULTS
Plasma VEGF levels in the HCC group were significantly higher than those of the non-HCC group, and both groups had significantly higher plasma VEGF levels than did the control group. Liver tissue VEGF expression was significantly higher in the HCC group than in the non-HCC group and positively correlated with plasma VEGF in the HCC group. The plasma VEGF levels were positively correlated with patients' age, aspartate aminotransferase levels, serum alpha-fetoprotein levels, the presence of portal vein thrombosis, and the number of hepatic focal lesions in the HCC group. However, plasma VEGF levels were not significantly correlated with the Child-Pugh score, alanine aminotransferase levels, the size of focal lesions, and Okuda stage. Using both the VEGF and alpha-fetoprotein levels to detect HCC maximizes the sensitivity and specificity.
CONCLUSION
Plasma levels of VEGF may be a useful diagnostic and prognostic marker for HCC in patients who have been diagnosed with CHC.
背景与目的
多种血管生成因子参与肝癌（HCC）的发生和发展，HCC 是一种富血管肿瘤。血管内皮生长因子（VEGF）是血管生成的主要驱动力，已有报道其在 HCC 中过度表达。然而，埃及慢性丙型肝炎（CHC）感染患者 HCC 中血浆和组织 VEGF 水平的意义尚未得到充分研究。本研究旨在评估 VEGF（在血浆和肝组织中测量）在丙型肝炎病毒相关 HCC 患者中的作用，并评估其在 HCC 的诊断和预后中的意义。
材料和方法
共研究了 90 例患者。在 90 例患者中，对 60 例 CHC 患者进行了检查，并分为两组：30 例 CHC 相关 HCC（HCC 组）和 30 例 CHC 无 HCC（非 HCC 组）。30 名健康受试者作为对照组。通过酶联免疫吸附试验测定血浆 VEGF，实时聚合酶链反应评价肝组织 VEGF 表达。还研究了 VEGF 表达水平及其与肿瘤参数、患者肝功能谱和患者临床参数的关系。
结果
HCC 组的血浆 VEGF 水平明显高于非 HCC 组，两组的血浆 VEGF 水平均明显高于对照组。HCC 组肝组织 VEGF 表达明显高于非 HCC 组，且与 HCC 组血浆 VEGF 呈正相关。HCC 组患者血浆 VEGF 水平与年龄、天冬氨酸转氨酶水平、血清甲胎蛋白水平、门静脉血栓形成的存在以及肝局灶性病变的数量呈正相关。然而，血浆 VEGF 水平与 Child-Pugh 评分、丙氨酸转氨酶水平、局灶性病变大小和 Okuda 分期无显著相关性。同时使用 VEGF 和甲胎蛋白水平检测 HCC 可最大限度地提高灵敏度和特异性。
结论
血浆 VEGF 水平可能是诊断和预测 CHC 患者 HCC 的有用标志物。
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