Expression of plasma vascular endothelial growth factor in patients with hepatocellular carcinoma and effect of transcatheter arterial chemoembolization therapy on plasma vascular endothelial growth factor level

摘要

AIM: To investigate the expression level of plasma vascularendothelial growth factor (P-VEGF) in patients withhepatocellular carcinoma (HCC) and its relationship withthe clinicopathologic characteristics, and to examine thechanges of P-VEGF in the course of transcatheter arterialchemoembolization (TACE).METHODS: Peripheral blood samples were taken from 45HCC patients before and 1, 3, 7 d, and 1 mo after TACE.Plasma VEGF level was measured with the quantitativesandwich enzyme-linked immunosorbent assay (ELISA).Twenty patients with benign liver lesions and 17 healthycontrol subjects were also included in this study.RESULTS: Plasma VEGF levels in HCC patients weresignificantly elevated as compared to those in patients withbenign liver lesions (P = 0.006) and in the normal controls(P = 0.003). Significant differences were observed whenP-VEGF was categorized by tumor size (P = 0.006), portalvein thrombosis (P= 0.011), distant metastasis (P= 0.017),arterial-portal vein shunting (P = 0.026), and InternationalUnion Against Cancer (UICC) TNM stage (P = 0.044). Therewas no correlation between plasma level of VEGF and thelevel of alpha fetoprotein (^-FP) (r = 0.068, P = 0.658) andweakly correlated with the number of platelets (r = 0.312,P = 0.038). P-VEGF levels increased significantly andreached the peak value on the first day after TACE, and thendecreased gradually. The change rate of P-VEGF concentration(one month post-TACE/pre-TACExl00%) was correlatedwith the retention rate of lipiodol oil (rs = 0.494, P= 0.001)and the tumor volume change (r s = 0.340, P = 0.034).The patients who achieved a partial or complete responseto TACE therapy showed significantly less pre-treatmentP-VEGF than those nonresponders (P = 0.025). A high pre-therapeutic P-VEGF level was associated with poor responseto treatment (P = 0.018).CONCLUSION: A high pre-treatment P-VEGF level is auseful marker for tumor nroeression, esBeciallv for vascularinvasion. TACE increases the level of P-VEGF onlytemporarily which may be associated with tumor ischemia.P-VEGF may be useful in predicting treatment response,monitoring disease course after TACE and judging the effectof different TACE regimens.