Objective: To explore the correlations between the serum levels of hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) and computed tomography (CT) perfusion parameters at pre- and post-transcatheter arterial chemoembolization (TACE) in patients with primary hepatic carcinoma (PHC).
Methods: A total of 22 PHC patients were recruited.Their serum levels of HIF-1α and VEGF were measured and CT perfusion imaging (CTPI) was performed at Day 1 pre- and Days 32-40 post-TACE to compare and analyze the relevance of the changes of serum levels of HIF-1α, VEGF, tumor's hepatic artery perfusion (HAP), portal vein perfusion (PVP) and hepatic artery perfusion index (HPI) at pre- and post-TACE.
Results: They were divided into stable and tumor residual/recurrent groups according to the efficacy of TACE. No significant differences existed between two groups with respects to serum levels of HIF-1α, VEGF, tumor's HAP, PVP and HPI pre-TACE. The serum levels of HIF-1α and VEGF decreased in stable group and there was significant difference in serum level of VEGF at Days 32-40 post-TACE (P < 0.05). There was no perfusion signal of HAP or PVP in tumor tissue.The serum levels of HIF-1α and VEGF were significantly higher while HAP and HPI were significantly lower than that pre-TACE in tumor residual/recurrent group and had statistical significance (P < 0.05), but PVP had no change.Positive correlations existed between serum levels of HIF-1α, VEGF and tumor's HAP, HPI at 32-40 days post-TACE.
Conclusion: Serum levels of HIF-1α and VEGF may indirectly reflect the status of neovascularization and CTPI acts as the intuitive and quantitative responses of hemodynamic changes at post-TACE.Positive correlations exist between serum levels of HIF-1α, VEGF, HAP and HPI. In short, a combination of serum levels of HIF-1α, VEGF and CTPI contributes to the efficacy evaluation of TACE and has great reference significance of determining timing of a second therapy.