Clinical Study In Vascular Sensitive Factors Of Angiogenesis Induced By Liver Cancer

Objective To study the inhibitory effect of Endostatin (ES) and the stimulative effect of Vascular endothelial growth factor (VEGF) on angiogenesis induced by liver cancer. To investigate the serum ES and VEGF levels and its fluctuation of each stage before or after curative resection of Primary liver cancer (PLC), and its relation with each other. To assay the sensitivity of determinating the serum ES levels associate with VEGF to prognose the potentials of metastasis and recurrence. To analysis the effect of the malajustment between the serum ES and VEGF levels on prognosis of PLC. Our ultimately aim to provide clinical testimony for elevate serum ES levels to control PLC recurrence and metastasis by gene recombine.Methods The limosis serum ES and VEGF levels were examined by ELISA in 30 patients with HCC or hepato-Cholangiocellular Carcinoma (hCCC ) 24 hour before and, 3 day, lOday, partial 3 month, partial 6month after curative resection. In addition, we examined serum levels of alpha-fetoprotein (AFP) and its fluctuation during the same stage as ES by automated chemiiluminescence system, and immunohistochemistry was applied in examined its pathological microvessel density (MVD) . Tumor size, capsule formation, portal vein tumor thrombus, number of planet focus or primary tumor, and recurrence and metastasis or not treatment as clinical data were obtained from Department of General Surgery, Anhui Provincial Hospital or FuDan university zhongshan Liver cancer institute, between 2000.1 and 2001.10 all HCC and iCCC were included in the study, the diagnosis were confirmed pathologically. In those 27 cases metastasis liver cancer (MLC), 30 cases healthy controls (HC), and 30 cases with decompensanted liver Cirrhosis (dLC) not accompanying HCC, only examined these items before operation.Results 1) The mean serum levels of ES (U g/mL) in patients with PLC, MLC, HC, and dLC were 711.4532 + 203.2998, 672.8111 + 123.0786, 686.1169?9.0571, 752.2480?355.9857, respectively, no significantly difference by statistics, P>0.05. Serum ES levels in patients with PLC decline after complete removal of tumor , and then elevated tardily, the mean of 3 day after in those patients ES levels lower than that of pre-operation and 6 month post-operation, respectively P<0.05. 2) Mean serum levels of VEGF (pg/mL) in those four groups were 437.2483 + 390.5288, 1747.1064+1091.9067, 423.3894 + 143.5601, 195.1215?121.4086, respectively. The serum levels of VEGF in patients with HCC show significantly higher than healthy controls (P < 0.05). Serum VEGF of metastasis liver cancer was highest among these patients (P<0.01). 3)The general mean of serum VEGF levels in patients with PLC before complete removal of tumor lower than that of after curative operation, specially lower than that of 6m after operation, /><0.05. More distinctly, when we analysis these patients serum VEGF levels differentiated by recurrence during 6 month post-operation or not , the mean of VEGF levels and its fluctuation in patients that recurrence during 6 month post-operation show higher than that of no-recurrences significantly(P<0.01). 4) Mean serum levels of AFP (u g/L) in those four kinds patients were 584.2197 + 635.4842, 22.4333 + 47.4291, 3.4833 + 0.7804, 77.5243+ 106.4307,respectively. Serum AFP levels in patients with HCC were highest while that in healthy were lowest among these four groups both show significantly different from others (P<0.01). 5) The serum level of ES and VEGF in patients with PLC and its fluctuation were negative-correlation (r=-0.3505), that of ES and VEGF were negative-correlation (r= - 0.4854) and positive-correlation (r=0.5208) with Microvessal density (MVD), respectively. The serum lower-expression of ES and / or hyper-expression of VEGF were correlative to haven't integrity capsule, portal vein tumor thrombus, more than one primary focus of tumor in liver. 6) Those patients who recurrence during 6 month post-operation have serum lower-expression of ES and / or hyper-expression of VEGF ,and angiogenicity of HCC is correlated...