| Objective:To compare the expression of B7-H3before and after interventional therapy in hepaticcarcinoma patients, then try to reveal the mechanism of tumor cell invasion, metastasis andthe effect on the immunologenicity of hepatic carcinoma cell on the molecule level, thus tosupply the biologic mechanism of immunologic escape of hepatic carcinoma, also cansupply the new method of diagnosis and evaluation index of the interventional therapy onhepatic carcinoma patients.Materials and methods:1. Ninty-three patients with advanced primary hepatic carcinoma (PHC) were enrolledin our study. All patients were diagnosised as PHC according to the clinical diagnosticcriteria for PHC or comfirmed by the histopathology. Thirty patients with Hepatitis B livercirrhosis were also enrolled in this study as control group at the same period.2. All93patients were underwent interventional procedures. Amnog them,73patientsaccepted transcatheter arterial chemoembolization (TACE) while20patients acceptedradiofrequency ablation (RFA) therapy.3.Observation indexs:①Study group: peripheral blood samples were collected3~5days before interventional procedures and one week after interventional procedures.Control group: peripheral blood samples were collected as the same period as the studygroups. Plasma B7-H3levels were detected by the quantitative sandwich enzyme-linkedimmunosorbent assay.②The dual-phase enhanced CT, MRI images were performed3~5days before procedures and one month after the procedures. All typical target lesions of theliver were measured, the maximum activity in diameter was caculated and reported as thesum of the longest diameter (SLD), to study the postprocedure responses of the target lesions with modified HCC RECIST criteria.③The obervations of the complications ofinterventioal procedures were recorded by the follow up terminal point(2013-01-31). Thesurvival time were also followed up in all patients.4.Statistical analysis: SPSS17.0statistic software, adopting t-test， chi-square test andLogistic regression analysis were applicated in this study. The statistcal difference issignificant when the P value was <0.05.Results:1. The changes of serum B7-H3expressThe pre-procedure serum B7-H3express in study group were:7.408±2.904ng/ml. Theserum B7-H3in control group were:11.928±5.432ng/ml. The pre-procedure serum B7-H3express in study group was lower than the serum B7-H3express of control group. Thestastistical difference was significant (P=0.001).The post-procedure serum B7-H3express in study group was:8.384±3.992ng/ml,which was higher than the pre-procedure express (7.408±2.904ng/ml), and the stastisticaldifference was also significant (P=0.008).2. The related factors of positive expression of B7-H3Positive expression standard: the post-procedure serum B7-H3express was higherthan the pre-procedure serum B7-H3express. The positive expression was related tometastasis, the AFP level and survival time. It was not related to gender, tumor size,pathological type and child-pugh score. The positive expression level was higher when thepatient had no matastasis, low AFP level and long survival time.3.The response of the target lesionInterventional procedures were performed on all of the93patients in the studygroup,which including29patients were PR (31%),21patients were CR (23%),26patientswere SD (28%), and17patients were PD (18%). Total effectiveness rate (PR+CR+SD)was82%。4. The complications after interventional procedureAccording to the results of follow-up (end time point of the follow-up:2013-01-31),the main complications were abdominal pain, nausea, sickness and fever, the scarcecomplications were ascites and hypoproteinemia.5. The relationship between survival time and related factorsThe patients survival time was related to some factors. It was significant related to the positive expression of serum B7-H3, the pathological type of the carcinoma and the distantmetastasis.Conclusions:1. The serum B7-H3express level of PHC patients were lower than the level ofhepatitis or cirrhosis patients, the difference was statistically significant.2. The post-procedure serum B7-H3express level of PHC patients was higher thanthe pre-procedure level, the difference was statistically significant.3. Interventional therapy cauld enhance the expression of serum B7-H3level.4. The survival time was longer in those patients whose post-procedure serum B7-H3express level were higher than the pre-procedure serum B7-H3level. |
