CAJ | 학술논문

目的：探讨索拉非尼治疗HBV相关性肝癌过程中，患者血清中血管内皮生长因子受体2（VEGFR-2）和甲胎蛋白（ APF）的水平变化。方法选取符合巴塞罗那诊断标准的中晚期HBV相关性肝癌患者46例，随机分为2组，每组23例，对照组给予抗HBV、对症、支持等常规治疗，治疗组在常规治疗的基础上加用索拉非尼400 mg口服，每天2次。6周为1个观察期。观察患者血清中VEGFR-2和AFP 水平的变化。结果对照组VEGFR-2水平在治疗前（8603．2 pg／ml ±573．4 pg／ml）后（8303．1 pg／ml ±527．7 pg／ml）无明显变化（ P ＞0．05）；治疗组在治后（6313．8 pg／ml ±559．9 pg／ml）明显低于治疗前（8401．1 pg／ml ±414．6 pg／ml），差异有统计学意义（ P ＜0．05），治疗组下降幅度大于对照组（ P ＜0．05）。对照组和治疗组治疗前AFP水平分别为100．8（25．0，1925．1） pg／ml和89．2（21．7，1567．2）pg／ml，治疗后分别为103．7（18．5，2083．2） pg／ml和78．4（21．6，684．3）pg／ml，2组AFP在治疗前后均无明显变化（ P ＞0．05）。 VEGFR-2与AFP水平无相关性（ r ＝－0．337， P ＝0．048）。结论索拉非尼能够降低肝癌患者血清中的VEGFR-2，对肝癌患者的临床治疗具有一定的指导意义。
목적：탐토색랍비니치료HBV상관성간암과정중，환자혈청중혈관내피생장인자수체2（VEGFR-2）화갑태단백（ APF）적수평변화。방법선취부합파새라나진단표준적중만기HBV상관성간암환자46례，수궤분위2조，매조23례，대조조급여항HBV、대증、지지등상규치료，치료조재상규치료적기출상가용색랍비니400 mg구복，매천2차。6주위1개관찰기。관찰환자혈청중VEGFR-2화AFP 수평적변화。결과대조조VEGFR-2수평재치료전（8603．2 pg／ml ±573．4 pg／ml）후（8303．1 pg／ml ±527．7 pg／ml）무명현변화（ P ＞0．05）；치료조재치후（6313．8 pg／ml ±559．9 pg／ml）명현저우치료전（8401．1 pg／ml ±414．6 pg／ml），차이유통계학의의（ P ＜0．05），치료조하강폭도대우대조조（ P ＜0．05）。대조조화치료조치료전AFP수평분별위100．8（25．0，1925．1） pg／ml화89．2（21．7，1567．2）pg／ml，치료후분별위103．7（18．5，2083．2） pg／ml화78．4（21．6，684．3）pg／ml，2조AFP재치료전후균무명현변화（ P ＞0．05）。 VEGFR-2여AFP수평무상관성（ r ＝－0．337， P ＝0．048）。결론색랍비니능구강저간암환자혈청중적VEGFR-2，대간암환자적림상치료구유일정적지도의의。
Objective To investigate the changes of serum of vascular endothelial growth factor receptor 2 ( VEGFR-2) and alpha fetal protein (AFP) levels for using sorafenib in the treatment of HBV related hepatocellular carcinoma (HCC). Methods 46 patients who meet the diagnostic criteria of Barcelona in the late stage of HBV related HCC patients were select-ed and divided into 2 groups, 23 cases in each group , the control group were treated with anti HBV , anti symptomatic , sup-portive and other conventional treatment , the treatment group were treated with sorafenib 400 mg orally on the basis of conven-tional therapy, 2 times a day.6 weeks as 1 observation period.Serum VEGFR-2 and AFP levels were observed in both of the 2 groups.Results Control group’s VEGFR-2’s level in before treatment (8 603.2 pg /ml ±573.4 pg /ml) and after treatment (8 303.1 pg /ml ±527.7 pg /ml) did not show significant changes ( P >0.05); treatment group’s after treat-ment’s level (6 313.8 pg /ml ±559.9 pg /ml) were significantly lower than those before treatment (8 401.1 pg/ml ± 414.6 pg/ml), the difference has statistical significance ( P <0.05).The treatment group’s index was decreased more than that of control group ( P <0.05).The control group and the treatment group ’ s AFP level before treatment were 100.8 (25.0,1 925.1) pg /ml and 89.2 (21.7, 1 567.2) pg /ml, after treatment were 103.7 (18.5.2 083.2) pg/ml and 78.4 (21.6, 684.3) pg/ml, respectively, before and after treatment, AFP had no obvious change in both of the two groups ( P >0.05).VEGFR 2 and AFP level had no correlation( r =-0.337, P =0.048).Conclusion Sorafenib can decrease VEG-FR 2 in patients with HCC , it has certain significance to the clinical treatment of liver cancer .