首页> 中文期刊> 《介入放射学杂志》 >血管内皮生长因子基因型对介入化疗栓塞治疗原发性肝癌预后的评估

血管内皮生长因子基因型对介入化疗栓塞治疗原发性肝癌预后的评估

         

摘要

Objective Through detecting the genotypes of vascular endothelial growth factor (VEGF) to investigate the correlation between the different VEGF genotypes and survival rate of patients with hepatocellular carcinoma (HCC) after receiving transcatheter arterial chemoembolization (TACE). Methods A total of 156 patients with pathologically confirmed HCC, who were admitted to authors’ hospital during the period from January 2008 to January 2009 and received TACE within 2 months after the disease was confirmed by pathology, were included in this study. The genotypes of VEGF-2578C/A, -1154G/A, -634C/G, and-1498T/C were determined using a blood kit on a 384-well plat. The clinical data were collected, and the correlations between the genotypes and the patient’s prognosis were analyzed. Results In this study, a total of four genotypes were detected, including VEGF-2578C/A, VEGF-1154G/A, VEGF-634C/G and VEGF-1498T/C. The mean 5-year survival rate was 55.47%. Multivariate analysis revealed that only the tumor-node-metastasis(TNM) stage, metastasis, and the VEGF-2578 AA and VEGF-1154 AA genotypes were independent prognostic factors. HCC of TNM stage Ⅲ-Ⅳ would greatly increase the risk of death in HCC patients (HR=3.64, 95%CI=1.67-6.79; HR=2.91, 95%CI=1.30-6.27). Moreover, the death risk in patients with the VEGF-2578 AA and VEGF-1154 AA genotypes was much higher than that in patients with the wild-type genotype (HR=3.65, 95%CI=1.35-11.13; HR=7.13, 95%CI=1.46-65.8). Conclusion VEGF-2578C/A genotype and VEGF-1154G/A genotype are closely related to the prognosis of HCC patients after TACE treatment, which may be helpful for predicting the clinical outcome of HCC patients after interventional treatment.%目的:通过检测血管内皮生长因子(VEGF)的基因类型,探讨不同类型基因与原发性肝癌(HCC)患者TACE术后生存率的关系。方法通过384孔板DNA提取试剂盒检测2007年1月到2008年1月156例经过病理确诊2个月内接受TACE治疗HCC患者的VEGF基因型并收集所有患者的临床资料,分析不同基因类型与患者预后的关系。结果本研究共检测出VEGF-2578C/A,VEGF-1154G/A, VEGF-634C/G和VEGF-1498T/C 4种基因型,患者的5年生存率为55.47%。经多变量分析显示,肿瘤分期(TMN)、癌灶转移、VEGF-2578 AA和VEGF-1154 AA基因型是独立预后因素。肝癌TMN分期为Ⅲ至Ⅳ期将极大增加肝癌患者死亡风险(HR=3.64,95%,CI=1.67-6.79;HR=2.91,CI=1.30-6.27)。然而VEGF-2578 AA 和VEGF-1154 AA 基因类型患者相比野生基因类型死亡风险更高(HR=3.65,95%CI=1.35-11.13;HR=7.13,95%CI=1.46-65.8)。结论 VEGF-2578C/A 和 VEGF-1154G/A 基因类型与接受TACE治疗的原发性肝癌患者预后密切相关,可能对预测介入治疗HCC的预后有一定帮助。

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