| Primary hepatic carcinoma, PHC or hepatocellular carcinoma, HCC, is one of the most common malignant tumor in our country. It developes fast and often companies with hepatic cirrhosis and hepatic metastasis, and a worse prognosis. Due to no obviously symptoms in the early stage, about 70 percent cases were diagnosed in advance stage. It is reported that one hundred and ten thouthands patients die of PHC every year in China that is about 45 percent in the world. PHC has influenced the public health in the world and our Country.The pathological progress of PHC is complicated and apoptosis may play a important role in it. Apoptosis associated cytokines, Fas and Fas Ligand system is related PHC development. Fas, receptor of Fas ligand (FasL) is a kind of important cytokine which can lead to apoptosis in vivo. The combination of Fas and FasL can induce apoptosis of target cell. Fas has two forms, membranous Fas (mFas) and soluble Fas (sFas). sFas is mainly distributed in serum and its key role is to prevent apoptosis induced by FasL-mFas through binding with FasL. Soluble Fas ligand (sFasL) also plays cytotoxic effect. Now, people pay more and more attention to Fas/FasL system. It is necessary to investigate the mechanisms of Fas/FasL in inhibiting PHC progression. Disodium cantharidinate vitamin B6 injection combined transcatheter hepatic arterial chemoembolization (TACE) is a new therapy to treat the advanced PHC patients who lost the operation chance. Therefore, it may provide a effective therapy for treating PHC by investigating the role of disodium cantharidinate vitamin B6 injection combined TACE on the expression of sFas and sFasL, and make clear how they prevent PHC progression. Objects: To investigate the effect of disodium cantharidinate vitamin B6 injection combined TACE on the expression of serum sFas and sFasL in the patients suffered from hepatocellular carcinoma.Methods:Twenty-six patients, age 54±7 years, suffered from PHC were enrolled in this investigation. The disease were diagnosed by ultrasound, computerized tomography or histopathology. These patients were treated with disodium cantharidinat vitamin B6 injection and TACE. 14 palindromia patients of PHC, 20 chronic hepatitis B patients and 20 healthy volunteers were served as compared control. Serum levels of sFas and sFasL were measured with enzyme linked immunosorbent assay (ELISA) at baseline and in 1, 3 and 6 months during the treatment. Serum biochemical markers included liver function and alpha fetoprotein (AFP).Results: 1. 26 patients with PHC liver founction were improved through the therapy and the order in base line, one month, three month and six months was following respectively, ALB is 33.0±6.1g/L,34.4±3.4g/L,36.6±5.2g/L,33.3±4.4g/L;ALT is 85.5±63.1U/L,75.2±44.5U/L,66.6±42.7U/L,79.3±48.6U/L; TB is 51.4±20.5umol/L,35.4±20.1umol/L,36.7±19.1umol/L,50.9±20umol/L.There were no obviously relation between the liver function and effect of the therapy. The level of AFP, in the patients of one month after treatment were increased(p<0.05), as well as in palindromia hepatoma patients .Those in the patients before treatment was higher than after three months and six months treatment. However, there was no significant difference between these groups.2. Serum sFasL and sFas level:①the level of sFasL were higher in CHB patients compared with the health control (p<0.01). sFasL and sFas content were up-regulated in PHC patients (p<0.01 and p<0.05), as well as in palindromia patients (p<0.01).②the expression of sFasL and sFas in PHC patients were increased than those in CHB group (p<0.01).③compared with palindromia hepatoma group:PHC patients'level of sFasL were up-regulated (p<0.01), the sFas level were down-regulated (p<0.01).④serum sFasL level was higher in the patients after one month treatment, the sFas level while was lower after 3 months threatment compared with before treatment (p<0.01, p<0.05); Compared to 1 month treatment, the level of sFasL after 3 months threatment was reduced (p<0.01) .⑥both the sFasL and the sFas was lower in the patients of 6 months treatment than baseline and after 3 month treatment (p<0.01).⑦in the patients after being treated for one, three and six months, both of the sFasL and sFas level were lower than that in the patients with palindromia carcinoma (p<0.01).Conclusion:1. In the PHC patients, the level of serum sFas and sFasL was increased compared with health control and hepatitis B patients, which indicated that sFas/sFasL system plays a important role in PHC development.2. The level of serum sFas and sFasL was decreasing after therapy with disodium cantharidinate vitamin B6 injection combined TACE as time delaying, the longer it went, the lower the level was. It show us that disodium cantharidinate vitamin B6 injection with TACE therapy can lead to apoptotic related genes expression and promoted tumor cell apoptosis, thus prevent the disease advance.
|
PDF Full Text Request