| Objectives：To observe the expression levels of vascular endothelial growth factor(VEGF),Interleukin8(IL-8) and AFP in patients with primary hepatocellular carcinoma; toobserve the changes of VEGF,IL-8before and after transcatheter arterialchemoembolization (TACE) treatment; to analyze the significance of VEGF,IL-8andAFP levels in the determination of efficacy and guidance of treatment; and toinvestigate the applicable conditions for the above.Methods：Ninety-two (92) patients, who had not received any previous treatment, with thediagnosis of primary hepatocellular carcinoma in our hospital were enrolled in thestudy. There were74males and18females, with the age range of26to82(mean:53.02±13.06) years.Patients were randomized according to quantity of iodized oil used duringTACE, surgical approach and size of the tumor in to the following groups; all ofthem were treated with transcatheter arterial chemoembolization: hepatic arterydosing group (20patients); highly selective tumor blood vessels dosing groups (72patients); iodized oil used during TACE greater than10ml group(69patients);iodized oil used during TACE less than10ml group(23patients); tumors less than5cm in maximum diameter group(19patients); and tumors larger than5cm inmaximum diameter group(73patients). Serum levels of VEGF, IL-8were detected atpre-operative TACE,1week post-operative TACE, and1month post-operativeTACE. Meanwhile, contrast enhanced CT of the upper abdominal andalpha-fetoprotein (AFP) examination were also performed. Group comparisons wereperformed, and to analyze the significance of VEGF, IL-8levels in the determinationof efficacy and guidance of treatment, and to investigate the applicable conditionsfor the above. Results:1. The expression level of AFP at1month post-operative TACE was decreasedsignificantly as compared with pre-operative level (P<0.05). The expression level ofVEGF at1week post-operative was decreased extremely significantly as comparedwith pre-operative level (P <0.01). No significant difference was observed whenVEGF level at1month post-operative TACE was compared with pre-operative level(P>0.05). The expression level of IL-8at1week post-operative TACE wasdecreased extremely significantly as compared with pre-operative level (P <0.01).There was significant difference when IL-8level at1month post-operative TACEwas compared with pre-operative level (P<0.05).2. Expression levels of AFP, VEGF and IL-8in patients with tumors larger than5cm in maximum diameter were significantly higher than those with tumor smallerthan5cm (p<0.05). The difference of expression levels of AFP pre-andpost-operative TACE was not significant, and the change was unrelated with theamount of iodized oil used during TACE (p>0.05). The differences of expressionlevels of VEGF and IL-8pre-and post-operative TACE were significant, and thechanges were related with the amount of iodized oil used during TACE (P<0.05).Administration route did not have significant influence on the changes of AFP,VEGF and IL-8pre-and post-operative TACE (p>0.05).3. The deterioration rate in patients with VEGF and IL-8levels decreased at1month post-operative TACE (the percentage of patients with the response of PD) wasno less than3%, while the deterioration rate in patients with VEGF and IL-8levelsincreased at1month post-operative TACE was no more than44.4%. In patients withthe response of PD, the percentage of patients with the IL-8level increased at1month post-operative TACE was83.3%.Conclusions:1. The expression levels of VEGF and IL-8were significantly higher in HCCpatients, and their levels were decreased after TACE.2. VEGF level was increased again after TACE, suggesting obvious tumorangiogenesis, and re-TACE was required.3. Patients with the expression level of IL-8increased significantly after TACEpossessed poor prognosis, and was prone to relapse and metastasis. 4. Patients with VEGF and IL-8levels decreased after TACE possessed goodefficacy, while patients with VEGF and IL-8levels increased possessed poorefficacy and prognosis. |
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