Abstract
Background and study aim: Hepato-cellular carcinoma (HCC) is a hypervascular tumor and its progression is known to be closely related to angiogenesis. Angio-poietin-2 (Ang-2) is one of the angiogenic factors that may have a diagnostic value in HCC. Alpha-fetoprotein (AFP) serum levels are used for screening for HCC with limited success. This study aimed to evaluate diagnostic value in using angio-poietin-2 as a serum marker in HCC patients. Patients and Methods: 50 patients with HCC (G1), 20 patients with liver cirrhosis (G2), and 20 healthy control persons (G3) were included in this study. Serum AFP and Ang-2 levels were measured by enzyme-linked immunosorbent assay. Results: Serum Ang-2 levels in the HCC group (1523.54±886.46 pg/ml) was highly significantly elevated as compared to those with cirrhotic liver (222.55±153.60 pg/ml) and controls (138.35±54.09 pg/ml). The Ang-2 levels were significantly different between patients with liver cirrhosis and controls. In HCC patients, the serum Ang-2 levels in patients with portal vein (PV) thrombosis (n=7, 2164.0±960.85 pg/ml) and with large HCC (>5cm in diameter) (n=17, 2017.70±903.06 pg/ml) were significantly higher than those without PV thrombosis (n=43, 1274.47±727.56 pg/ml) and with small HCC (≤5cm in diameter) (n=33, 1268.97±773.93 pg/ml), while the serum AFP levels in patients with portal vein (PV) thrombosis (961.05±1007.70 ng/ml) and with large HCC (>5cm in diameter) (1000.81±1079.57 ng/ml) were not significantly higher than those without PV thrombosis (500.24±733.07 ng/ml) and with small HCC (437.87±611.02 ng/ml). Conclusion: Combined measurement of serum AFP and Ang-2 significantly increases the sensitivity and specificity of HCC detection rather than using of AFP or Ang-2 separately.
Highlights
Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide, and the third cause of cancerrelated death [1].Development of HCC is known to be triggered by factors that lead to chronic hepatic injury and deregulation of the normal process of wound healing, which promote persistent stimulation of profibrotic and proangiogenic processes that lead to significant structural changes in the liver and functional changes in hepatic physiology [2].When tumor size reaches a critical size, the angiogenic switch enables the tumor to grow vessels that allow further growth and metastatic spread [3]
The Ang-2 levels were significantly different between patients with liver cirrhosis and controls
Mean Ang-2 serum levels were with a high significant difference between patients with HCC in all Child categories, cirrhotic patients and control (Table 4)
Summary
Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide, and the third cause of cancerrelated death [1].Development of HCC is known to be triggered by factors that lead to chronic hepatic injury and deregulation of the normal process of wound healing, which promote persistent stimulation of profibrotic and proangiogenic processes that lead to significant structural changes in the liver and functional changes in hepatic physiology [2].When tumor size reaches a critical size, the angiogenic switch enables the tumor to grow vessels that allow further growth and metastatic spread [3]. Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide, and the third cause of cancerrelated death [1]. Factors involved in neovessel formation in HCC include vascular endothelial growth factor (VEGF) and the angiopoietins (Ang) [5]. Angiopoietin-1 and -2 bind toTie-2, which is expressed on endothelial cells, in a competitive manner [6]. Hepatocellular carcinoma (HCC) is a hypervascular tumor and its progression is known to be closely related to angiogenesis. Angiopoietin-2 (Ang-2) is one of the angiogenic factors that may have a diagnostic value in HCC. This study aimed to evaluate diagnostic value in using angiopoietin-2 as a serum marker in HCC patients
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