关键词: 中晚期原发性肝癌, 经导管动脉化疗栓塞, 预后, 血管内皮生长因子, 血管内皮生长因子受体

Abstract: Objective To investigate the relationship between serum vascular endothelial growth factor receptor 2 (VEGFR-2), vascular endothelial growth factor receptor 3 (VEGFR-3) and curative effect in patients with advanced primary liver cancer of transcatheter arterial chemoembolization (TACE) therapy. Methods Seventy patients with advanced primary liver cancer who received TACE therapy from January 2017 to January 2019 in our hospital were selected. The serum VEGFR-2, VEGFR-3 expression levels of patients were detected 1 day before TACE and 7 days after TACE therapy, The relationship among VEGFR-2, VEGFR-3 and short-term efficacy, overall survival (OS) were analyzed. Results The reduction rates of VEGFR-2 (59.52%) and VEGFR-3 (57.14%) in patients with remission were higher than those in patients without remission (32.14%,57.14%, P<0.05). The rate of Child-Pugh B (77.8%), the rate of liver cirrhosis (55.6%), the tumor maximum diameter (4.69 ± 1.58) cm, the serum alpha fetoprotein (AFP) level [489.8 (452.9) μg/mL], and vascular endothelial growth factor (VEGF) level [(335.7 ± 55.8) pg/mL] of patients whose serum VEGFR-2 levels did not reduce were higher, compared with those of the patients whose serum VEGFR-2 levels reduced [47.1%, 26.5%, (3.89 ± 1.46) cm, 428.6 (389.5) μg/mL, (248.9 ± 46.9) pg/ml, the differences were statistically significant, P<0.05]. The rate of Child-Pugh B (85.3%), the rate of liver cirrhosis (55.9%), the tumor maximum diameter [(4.71 ± 1.67) cm], the serum AFP level [488.6 (462.0) μg/mL] and VEGF level [(322.9 ± 56.1) pg/mL] of patients whose serum VEGFR-3 levels did not reduce were higher, compared with those of the patients whose serum VEGFR-3 levels reduced (41.7%, 27.8%, (3.91 ± 1.39) cm, 431.5 (391.2) μg/mL, (253.6 ± 51.0) pg/mL, the differences were statistically significant, P<0.05). Patients were followed up from 15 to 34 months (23.9 ± 3.8 months on average), but 6 cases were lost. Kaplan-Meier method and Log-rank test showed that patients with reduced VEGFR-2 or VEGFR-3 had a higher cumulative OS rate than those without reduction (the differences were statistically significant, P<0.05). Receiver operator characteristic (ROC) curve showed that the serum levels of VEGFR-3 and VEGFR-2 had high value in predicting the survival of patients with primary liver cancer (area under the curve = 0.84, P=0.000, 95%CI=0.77-0.94), with a specificity of 72.3% and a sensitivity of 86.9%. Conclusion The changes on the preoperative and postoperative levels of VEGFR-2 and VEGFR-3 are related to prognosis in patients with advanced primary liver cancer treated by TACE. The serum levels of VEGFR-2 and VEGFR-3 can be used to predict the survival of patients and may become prognostic markers for advanced primary liver cancer.

Key words: Advanced primary liver cancer, Transcatheter arterial chemoembolization, Prognosis, Vascular endothelial growth factor, Vascular endothelial growth factor receptor