摘要
目的评价血管拟态(VM)对原发性肝癌(HCC)接受肝癌经血管栓塞化疗(TACE)有效应答及无进展生存(PFS)的影响。方法单中心回顾性设计,连续纳入扬州大学附属泰州市第二人民医院肿瘤介入科2014年7月1日-2016年7月31日接受TACE术的HCC患者129例,PAS-CD34双染色检测穿刺活检标本VM。术后每3月随访。分析VM与TACE术后应答及PFS的关系。结果纳入研究的129例患者,有效病例79例(61.24%),2例完全缓解,77例部分缓解;无效病例50例(38.76%),疾病稳定16例,疾病进展34例。有效病例中检出VM者为6例(7.59%,6/79),而无效病例中检出VM者为38例(76.00%,38/50),2组之间具有显著性差异(P <0.001)。VM阳性患者中位PFS为9.87月(95%CI:[8.76,10.99]),阴性患者中位PFS为22.57月(95%CI:[22.00, 23.15]),2者之间具有显著性差异(P <0.001)。VM是HCC接受TACE术后预后的独立危险因素(HR=4.368, P <0.001)。结论 VM阳性HCC接受TACE术治疗应答率下降,无进展生存显著缩短,需要进一步的临床及基础研究。
Objective To evaluate the association of vasculogenic mimicry(VM) with the response totranscatheter arterial chemoembolization(TACE) and the efficacy on progression-free survival(PFS) in primary hepatocellular carcinoma(HCC). Methods It was a single-centered, retrospective analysis. Continuous HCC cases receiving TACE from July 1 st, 2014 to July 31 st, 2016 in the Department of Cancer Intervention of The Second People’s Hospital of Taizhou Afficiated to Yangzhou University were included. VM was detected by PAS-CD34 double staining. All post-TACE patients were followed up every 3 months. The relationships between VM and post-TACE response and PFS were analyzed. Results A total of 129 cases were included in the study, of which 79(61.24%) had response and 50(38.76%) no response. VM was detected in 6 of the response patients(7.59%, 6/79) and 38 of the nonresponse patients(76.00%, 38/50). There was a significant difference between the two groups(P < 0.001). The median PFS of VM positive patients was 9.87 months(95%CI: [8.76, 10.99]) and that of negative patients was 22.57 months(95% CI: [22.00, 23.15]). There was significant difference between the two groups(P < 0.001). VM was an independent risk factor for prognosis of HCC after TACE(HR=4.368, P < 0.001). Conclusion The response rate of VM-positive HCC to TACE treatment was miserable, and the PFS was significantly shortened. Further clinical and basic research is needed.
作者
何学军
张志胜
陈高阳
钱厚龙
崔林
刘延庆
陈珏
He Xue-jun;Zhang Zhi-sheng;Chen Gao-yang;Qian Hou-long;Cui Lin;Liu Yan-qing;Chen Jue(Department of Cancer Intervention,The Second People’s Hospital of Taizhou Affiliated to Yangzhou University,Jiangyan 225500,Jiangsu,China;Oncology Institute,Yangzhou University,Yangzhou 225000,Jiangsu,China)
出处
《兰州大学学报（医学版）》
CAS
2020年第1期30-35,41,共7页
Journal of Lanzhou University（Medical Sciences）
基金
国家自然科学基金资助项目(81274141)
江苏省自然科学基金资助项目(SBK201822212)
江苏省泰州市高层次人才项目(RCPY201833)。
关键词
原发性肝癌
血管拟态
经血管栓塞化疗
无进展生存
primary hepatocellular carcinoma
vasculogenic mimicry
transcatheter arterial chemoembolization
progression-free survival
