ABSTRACT
BACKGROUND/AIMS: To explore the effect of vascular endothelial growth factor (VEGF) expression on prognosis of hepatocellular carcinoma (HCC) after partial liver resection. METHODOLOGY: The expression of VEGF in 64 preoperative serum and resection specimens of HCC, confirmed by pathology, was detected by enzymelinked immunosorbent assay (ELISA) and immunohistochemistry. Correlations of VEGF level to clinicopathological features were analyzed. Cox regression model was used to analyze the recurrence risk factors after hepatectomy. RESULTS: Serum level of VEGF in HCC patients was 334.50±247.62pg/mL, significantly higher than healthy control group (p<0.01); it was also significantly higher in recurrent group than in non-recurrent group (p<0.05). VEGF was expressed in cytoplasm of HCC specimens. The positive rates of VEGF was significantly higher in recurrent group than in non-recurrent group (85.0% vs. 54.5%, p<0.05). The 1-, 2- and 3-year disease-free survival rates were significantly higher in VEGF(-) group than in VEGF(+) group (81.3% vs. 52.2%, 68.8% vs. 33.3%, and 62.5% vs. 29.1%, p<0.01). The overall survival rates of VEGF(-) subgroup was borderline significant higher than that of VEGF(+) subgroup (p=0.068). Multivariate analysis revealed that preoperative macroscopically disseminated nodules, tumor micrometastasis, serum and tissue VEGF level were independent recurrence risk factors. CONCLUSIONS: Serum and tissue VEGF level of HCC patients ascends distinctly, correlates to the recurrence of HCC after partial liver resection which can be used to estimate the risk of postoperative recurrence of HCC.
Subject(s)
Biomarkers, Tumor/analysis , Carcinoma, Hepatocellular/chemistry , Carcinoma, Hepatocellular/surgery , Hepatectomy , Liver Neoplasms/chemistry , Liver Neoplasms/surgery , Vascular Endothelial Growth Factor A/analysis , Biomarkers, Tumor/blood , Carcinoma, Hepatocellular/mortality , Carcinoma, Hepatocellular/secondary , Chi-Square Distribution , China , Disease-Free Survival , Enzyme-Linked Immunosorbent Assay , Female , Hepatectomy/adverse effects , Hepatectomy/mortality , Humans , Immunohistochemistry , Kaplan-Meier Estimate , Liver Neoplasms/mortality , Liver Neoplasms/pathology , Male , Multivariate Analysis , Neoplasm Micrometastasis , Neoplasm Recurrence, Local , Proportional Hazards Models , Retrospective Studies , Risk Assessment , Risk Factors , Survival Rate , Time Factors , Treatment Outcome , Up-Regulation , Vascular Endothelial Growth Factor A/bloodABSTRACT
BACKGROUND & OBJECTIVE: Transcatheter arterial chemoembolism (TACE) is one of important therapeutic method for hapatocarcinoma. Post-operative TACE could reduce recurrent rate definitely. However, there were much debate about the function and effect of preoperative TACE. This study was conducted to evaluate the effect of preoperative TACE on immunity of the patients with recurrent hepatocarcinoma who performed combined treatment. METHODS: The patients with primary hepatocarcinoma who performed operative TACE were collected. The dynamic changes of cellular immunity and humoral immunity in pre-intervention, pre-operation, combined treatment after recurrence periods were determined by flow cytometry and ELISA, and were compared with the data of the recurrent patients after simple operation. RESULTS: In TACE group: CD3, CD4, CD56 decreased slightly; serum IgM increased slightly, with no significant difference compared to pre-intervention (P < 0.05); At the time of combined treatment after recurrence, CD8 increased and CD4/CD8 decreased (0.8 +/- 0.3%), the immune suppression was slight. In sample operation group, CD3, CD4, CD56 were 49.0 +/- 9.1%, 19.0 +/- 4.8%, 18.6 +/- 9.9%; the immune suppression was severe. The operation significantly decreased the patients' CD3, CD4, and CD19. The pathologic results showed that the tumor capsule, intrahepatic daughter foci, tumor thrombus, and the radical degree in preoperative group were much better than those in simple operation group. CONCLUSION: The preoperative TACE do not obviously influence the immunity; furthermore, it can relieve the immune depression after operation and is a remedy of the surgical treatment. It is important to grasp the indication of preoperative TACE.
