Immunohistochemical assessment of angiogenesis in primary hepatocellular carcinoma
Adrian Săftoiu1, Tudorel Ciurea, Monica Baniţă
1Department of Internal Medicine, Division of Gastroenterology, University of Medicine and Pharmacy, Str. Horia no.11, Craiova, Romania. adry@umfcv.ro
Background:
Primary hepatocellular carcinoma (HCC) is characterized by the presence of angiogenesis, which is necessary for tumor growth, progression and distant metastasis. Vascular endothelial growth factor (VEGF) is clearly expressed in HCC, in variable degrees as a function of differentiation and vascularisation.
Aim:
To assess angiogenesis in HCC, by means of immunohistochemical analysis of the expressions of VEGF.
Method:
Immunohistochemical techniques were performed on the samples obtained by ultrasound-guided liver biopsies or intraoperative biopsies, in 32 patients with HCC.
Results:
Positive expression of VEGF was always observed in the extracellular matrix of portal tracts of the non-neoplastic or tumor areas (extra- and intranodular areas of HCC patients). VEGF was not expressed inside the hepatocytes of extranodular non-neoplastic areas of the patients with HCC. However, we did find positive reactions for VEGF inside the tumor hepatocytes in 34.38 % of the HCC patients. The difference between VEGF expression for the patients with poor and undifferentiated HCC as compared with moderate and well-differentiated HCC was statistically significant (P < 0.05).
Conclusion:
Our study demonstrated an increased VEGF expression in tumor hepatocytes, which progressed with the dedifferentiation of HCC. VEGF expression was always present in the extracellular matrix, supporting the hypothesis of paracrine activation of VEGF at the level of tumor stroma. Consequently, increased VEGF expression might be responsible for the activation of angiogenesis in HCC.
