CAJ | 학술논문

目的：通过检测血管内皮生长因子（VEGF）的基因类型，探讨不同类型基因与原发性肝癌（HCC）患者TACE术后生存率的关系。方法通过384孔板DNA提取试剂盒检测2007年1月到2008年1月156例经过病理确诊2个月内接受TACE治疗HCC患者的VEGF基因型并收集所有患者的临床资料，分析不同基因类型与患者预后的关系。结果本研究共检测出VEGF-2578C/A，VEGF-1154G/A， VEGF-634C/G和VEGF-1498T/C 4种基因型，患者的5年生存率为55.47%。经多变量分析显示，肿瘤分期（TMN）、癌灶转移、VEGF-2578 AA和VEGF-1154 AA基因型是独立预后因素。肝癌TMN分期为Ⅲ至Ⅳ期将极大增加肝癌患者死亡风险（HR=3.64，95%，CI=1.67-6.79；HR=2.91，CI=1.30-6.27）。然而VEGF-2578 AA 和VEGF-1154 AA 基因类型患者相比野生基因类型死亡风险更高（HR=3.65，95%CI=1.35-11.13；HR=7.13，95%CI=1.46-65.8）。结论 VEGF-2578C/A 和 VEGF-1154G/A 基因类型与接受TACE治疗的原发性肝癌患者预后密切相关，可能对预测介入治疗HCC的预后有一定帮助。
목적：통과검측혈관내피생장인자（VEGF）적기인류형，탐토불동류형기인여원발성간암（HCC）환자TACE술후생존솔적관계。방법통과384공판DNA제취시제합검측2007년1월도2008년1월156례경과병리학진2개월내접수TACE치료HCC환자적VEGF기인형병수집소유환자적림상자료，분석불동기인류형여환자예후적관계。결과본연구공검측출VEGF-2578C/A，VEGF-1154G/A， VEGF-634C/G화VEGF-1498T/C 4충기인형，환자적5년생존솔위55.47%。경다변량분석현시，종류분기（TMN）、암조전이、VEGF-2578 AA화VEGF-1154 AA기인형시독립예후인소。간암TMN분기위Ⅲ지Ⅳ기장겁대증가간암환자사망풍험（HR=3.64，95%，CI=1.67-6.79；HR=2.91，CI=1.30-6.27）。연이VEGF-2578 AA 화VEGF-1154 AA 기인류형환자상비야생기인류형사망풍험경고（HR=3.65，95%CI=1.35-11.13；HR=7.13，95%CI=1.46-65.8）。결론 VEGF-2578C/A 화 VEGF-1154G/A 기인류형여접수TACE치료적원발성간암환자예후밀절상관，가능대예측개입치료HCC적예후유일정방조。
Objective Through detecting the genotypes of vascular endothelial growth factor (VEGF) to investigate the correlation between the different VEGF genotypes and survival rate of patients with hepatocellular carcinoma (HCC) after receiving transcatheter arterial chemoembolization (TACE). Methods A total of 156 patients with pathologically confirmed HCC, who were admitted to authors’ hospital during the period from January 2008 to January 2009 and received TACE within 2 months after the disease was confirmed by pathology, were included in this study. The genotypes of VEGF-2578C/A, -1154G/A, -634C/G, and-1498T/C were determined using a blood kit on a 384-well plat. The clinical data were collected, and the correlations between the genotypes and the patient’s prognosis were analyzed. Results In this study, a total of four genotypes were detected, including VEGF-2578C/A, VEGF-1154G/A, VEGF-634C/G and VEGF-1498T/C. The mean 5-year survival rate was 55.47%. Multivariate analysis revealed that only the tumor-node-metastasis(TNM) stage, metastasis, and the VEGF-2578 AA and VEGF-1154 AA genotypes were independent prognostic factors. HCC of TNM stage Ⅲ-Ⅳ would greatly increase the risk of death in HCC patients (HR=3.64, 95%CI=1.67-6.79; HR=2.91, 95%CI=1.30-6.27). Moreover, the death risk in patients with the VEGF-2578 AA and VEGF-1154 AA genotypes was much higher than that in patients with the wild-type genotype (HR=3.65, 95%CI=1.35-11.13; HR=7.13, 95%CI=1.46-65.8). Conclusion VEGF-2578C/A genotype and VEGF-1154G/A genotype are closely related to the prognosis of HCC patients after TACE treatment, which may be helpful for predicting the clinical outcome of HCC patients after interventional treatment.