阿帕替尼联合TACE术对肝细胞癌患者血清VEGF/TSFG水平的影响

摘要/Abstract

摘要： 目的了解阿帕替尼联合经肝动脉化疗栓塞术(TACE)对肝细胞癌患者血清血管内皮生长因子(VEGF)/肿瘤特异性生长因子(TSFG)水平的影响。方法纳入2018年8月至2020年8月于江苏省人民医院收治的120例肝细胞癌患者,按照随机数表法将患者分为两组,各60例,其中对照组行TACE治疗,观察组在对照组基础上联合阿帕替尼治疗。比较两组治疗前后VEGF/TSFG、甲胎蛋白(AFP)、基质金属蛋白酶-9(MMP-9)水平、CD3⁺T淋巴细胞、CD4⁺/CD8⁺分布情况。结果观察组和对照组治疗有效率分别为60.00%(36/60)、36.67%(22/60),两组比较差异有统计学意义(χ²=6.541,P=0.011)。观察组治疗后6 d VEGF/TSFG为(411.20±50.21),低于治疗前的(500.25±50.23),高于治疗后3个月的(324.64±51.12),差异均有统计学意义(均P<0.05);对照组治疗后6 d VEGF/TSFG为(454.27±49.58),低于治疗前的(512.25±55.92)和治疗后3个月的(532.48±56.48),差异均有统计学意义(均P<0.05)。两组治疗后MMP-9、AFP均显著低于治疗前(P<0.05),CD3⁺T淋巴细胞、CD4⁺/CD8⁺均显著高于治疗前(P<0.05);观察组治疗后MMP-9为(968.76±201.48)ng/L、AFP为(489.47±32.49)μg/L,均低于对照组的(1632.49±245.86)ng/L、(743.58±49.58)μg/L,差异均有统计学意义(均P<0.05),CD3⁺T淋巴细胞为(61.58±9.36)%、CD4⁺/CD8⁺为(1.09±0.12)均高于对照组的(54.24±8.59)%、1.34±0.19,差异均有统计学意义(均P<0.05)。结论阿帕替尼联合TACE术可有效调节肝细胞癌患者血清VEGF/TSFG水平,抑制肿瘤血管新生。

关键词: 肝细胞癌, 经肝动脉化疗栓塞术, 阿帕替尼, 血管内皮生长因子, 肿瘤特异性生长因子

Abstract: Objective To investigate the effect of apatinib combined with transcatheter arterial chemoembolization (TACE) on serum vascular endothelial growth factor (VEGF)/tumor specific growth factors (TSGF) levels in patients with hepatocellular carcinoma (HCC). Methods A total of 120 patients with HCC admitted to our hospital from August 2018 to August 2020 were selected, and randomly divided into 2 groups on average. The control group was treated with TACE, and the observation group was treated with apatinib combined with TACE. The treatment efficacy of the 2 groups were analyzed, and the levels of VEGF/TSGF, alpha fetoprotein (AFP), matrix metalloproteinase-9 (MMP-9) and the distribution of T lymphocyte subsets CD3⁺, CD4⁺/CD8⁺ were compared before and after treatment. Results The effective rates of the observation group and the control group were 60.00% and 36.67%, respectively, and the difference was statistically significant (P<0.05). In observation group, the level of VEGF/TSGF at 6 days after treatment (411.20±50.21) was significantly lower than that before treatment (500.25±50.23, P<0.05). Three months after treatment, the level of VEGF/TSGF (324.64±51.12) was significantly lower than that before treatment and 6 days after treatment (500.25±50.23, 411.20±50.21, P<0.05). The level of VEGF/TSGF in control group (454.27±49.58) at 6 days after treatment was significantly lower than that before treatment (512.25±55.92, P<0.05), and 3 months after treatment, the level of VEGF/TSGF (532.48±56.48) was significantly higher than that at 6 days after treatment (454.27±49.58, P<0.05). The levels of VEGF/TSGF at 6 days and 3 months after treatment in observation group (411.20±50.21, 324.64±51.12) were significantly lower than those in control group (454.27±49.58, 532.48±56.48, P<0.05). After treatment, the levels of MMP-9 and AFP in the 2 groups were significantly lower than those before treatment (P<0.05), whereas CD3⁺ and CD4⁺/CD8⁺ were significantly higher than those before treatment (P<0.05). After treatment, the levels of MMP-9 [(968.76±201.48) ng/L] and AFP [(489.47±32.49) μg/L] in observation group were significantly lower than those in control group [(1632.49±245.86)ng/L, (743.58±49.58)μg/L, P<0.05], whereas CD3⁺ [(61.58±9.36)%], CD4⁺/CD8⁺ (1.09±0.12) were significantly higher than those in control group [(54.24±8.59)%, 1.34±0.19, P<0.05]. Conclusion Apatinib combined with TACE in the treatment for patients with HCC can effectively regulate the serum VEGF/TSGF levels and inhibit tumor angiogenesis.

Key words: Hepatocellular carcinoma, Transcatheter arterial chemoembolization, Apatinib, Vascular endothelial growth factor, Tumor specific growth factor

张敏花, 朱德明, 仲晨. 阿帕替尼联合TACE术对肝细胞癌患者血清VEGF/TSFG水平的影响[J]. 肝脏, 2021, 26(11): 1260-1263.

ZHANG Min-hua, ZHU De-ming, ZHONG Chen. Effect of apatinib combined with TACE on serum VEGF/TSGF levels in the treatment for patients with HCC[J]. Chinese Hepatolgy, 2021, 26(11): 1260-1263.

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