Expression of Vascular Endothelial Growth Factor in the Gastric Mucosa of Patients with Portal Hypertensive Gastropathy

Abstract

Background and study aim: Portal hypertensive gastropathy (PHG) is a common finding in patients with cirrhosis and portal hypertension that occurs in between 7% and 98% of cases. High levels of vascular endothelial growth factor (VEGF) in mesentery suggested their contribution in portal hypertension secondary to liver cirrhosis. VEGF participates in regulation of angiogenesis in gastric wall in portal hypertension. The aim was to evaluate the serum concentration of VEGF and gastric mucosal expression of VEGF and its possible association with PHG. Patients and Methods: Serum levels and gastric mucosal expression of VEGF were measured in fifty seven patients with liver cirrhosis and portal hypertensive gastropathy as well as eleven patients with liver cirrhosis without portal hypertensive gastropathy and another twenty one persons served as control group. They were clinically assessed and laboratory investigations were done including liver biochemical profile, and viral markers. Severity of liver disease was assessed by Child-Pugh, model for end stage liver disease (MELD) and updated (uMELD) scores. The presence of PHG was diagnosed by esophago-gastroduodenoscopy. Results: Serum VEGF increased in patients with liver cirrhosis compared to healthy control. But there was no significant difference between patients with PHG and patients without PHG as regard to serum VEGF.VEGF expression in the gastric mucosa was highly significant in patients with PHG than patients without PHG and control group. Serum VEGF has no correlation with severity of liver disease or PHG grade. Conclusion: VEGF was highly expressed in gastric mucosa rather than elevation of serum VEGF in patients with PHG.