Objective: To investigate the expression levels of serum hypoxia inducible factor 1 alpha (HIF-1alpha) and vascular endothelial growth factor (VEGF) pre- and post-transcatheter arterial chemoembolization (TACE) in patients with primary liver cancer (PLC), and correlations between prognosis factors and serum HIF-1alpha as well asVEGF levels.
Methods: Forty consecutive patients fulfilling diagnostic criteria for PLC undergoing TACE from March 2008 to May 2009 were enrolled into the study. The serum HIF-1alpha and VEGF levels of PLC patients pre- and 1 day, 1 week, 1 month post-TACE were analyzed using ELISA, and compared with that of 20 healthy volunteers. Patients were divided into complete response (CR) and partial response (PR), stable disease (SD), progressive disease (PD) groups according to the therapeutic efficacy. Pearson correlation was used to analyze the correlation between different clinical variables and serum HIF- 1alpha and VEGF levels before TACE, and correlation between serum HIF-1alpha and VEGF levels was also evaluated.
Results: The expression levels of serum HIF-1alpha and VEGF in PLC patients were 154.94 +/- 83.29 and 264.00 +/- 148.10 pg/mL pre-TACE, and both of them were significantly higher than those in control group (23.84 +/- 8.15 and 69.78 +/- 21.42 pg/mL, all P<0.01). One day after TACE, both serum HIF-1alpha (570.64 +/- 230.87 pg/mL) and VEGF levels (362.07 +/- 102.25 pg/mL) reached the peak values (all P<0.01). One week post-TACE, expression levels of them were decreased (198.62 +/- 92.11 and 283.52 +/- 145.46 pg/mL respectively), but still significantly higher than those before TACE (all P<0.01). The levels of both HIF-1alpha (133.96 +/- 57.02 vs. 255.74 +/- 123.44 pg/mL) and VEGF (150.96 +/- 84.89 vs. 368.95 +/- 161.90 pg/mL) in CR group 1 month post-TACE were significantly lower than those in PR+SD+PD group (all P<0.01). The level of serum HIF-1alpha was positively correlated with serum VEGF level (r=0.42, P<0.001). Both serum HIF-1alpha and VEGF levels were observed to be correlated with portal vein tumor thrombi (P<0.05) and metastasis (P<0.05).
Conclusion: The HIF- 1alpha and VEGF might play an important role in relapse of PLC. They might be considered as predictors of the efficacy ofTACE and metastasis of PLC.