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目的研究肝细胞癌(hepatocellularcarcinoma,HCC)经导管动脉化疗栓塞(transcatheterarterialchemoembolization,TACE)后残癌组织微血管密度(microvesseldensity,MVD)、微血管直径、血管内皮细胞生长因子(vascularendothelialgrowthfactor,VEGF)的表达情况及其意义。方法经病理证实的HCC63例,包括单纯手术切除42例(对照组),TACE术后行Ⅱ期手术切除21例(TACE组)。TACE组患者手术前接受1~2次不等的TACE治疗,均按统一规范标准给予化疗药物灌注+栓塞治疗。对手术切除标本进行免疫组织化学染色,其中TACE组取病灶边缘残存肿瘤部分,检测肿瘤组织的MVD、微血管直径及肿瘤细胞VEGF的表达。结果对照组MVD值为(5169±1817)条,TACE组MVD值为(5857±1575)条,二者之间比较差异无统计学意义(t=148,P>005);对照组微血管直径为(1762±1054)μm,TACE组微血管直径为(1579±765)μm,二者之间比较差异无显著性意义(t=071,P>005)。对照组VEGF阳性染色细胞数为13826±6524,TACE组VEGF阳性染色细胞数为24366±8888,二者之间比较差异有统计学意义(t=534,P<001),TACE显著上调了VEGF蛋白的表达;VEGF阳性染色细胞数与MVD明显相关(r=04936,t=44329,P<005)。结论化疗栓塞术后残癌组织存在丰富的肿瘤血供,残癌组织肿瘤细胞VEGF表达明显升
Objective To study the expression of microvessel density (MVD), microvessel diameter and vascularendothelial growth factor (VEGF) in hepatocellularcarcinoma (HCC) after transcatheter arterial chemoembolization (TACE) significance. Methods Totally 63 HCC patients were pathologically confirmed, including 42 cases of simple surgical resection (control group) and 21 cases of TACE (TACE group). Patients in TACE group received 1 ~ 2 times of TACE before surgery, and were given chemotherapeutic drug infusion and embolization according to uniform standard. Immunohistochemical staining was performed on the resected specimens. TACE group was used to detect the residual tumor in the margins of the lesions, and to detect the MVD, the diameter of microvessels and the expression of VEGF in tumor cells. Results The MVD of the control group was (5169 ± 1817) and that of the TACE group was (5857 ± 1575), there was no significant difference between the two groups (t = 148, P> 005) (1762 ± 1054) μm, TACE group microvessel diameter (1579 ± 765) μm, no significant difference between the two (t = 071, P> 005). The number of VEGF-positive cells in control group was 13826 ± 6524, the number of VEGF-positive cells in TACE group was 24366 ± 8888, the difference was statistically significant (t = 534, P <001) The number of VEGF-positive cells was significantly correlated with MVD (r = 04936, t = 44329, P <005). Conclusion There are abundant blood supply to the residual cancer tissue after chemotherapy and embolization, and the expression of VEGF in the residual tumor tissue is significantly higher