Serum vascular endothelial growth factor is a potential biomarker of metastatic recurrence after curative resection of hepatocellular carcinoma.

Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignancies in China. To date, surgery is still the best solution to it. However, metastatic recurren ces after curative hepatic resections are very common. Tang et al[1] have repor ted that recurrence rate within 5 years of curative hepatic resection is 61.5%. As curative hepatic resection has a high tendency for metastatic recu rrence, therapeutic interventions such as transarterial embolization and antiang i ogenesis have been tried to further improve prognosis of HCC patients. Therefore, establishing a dependable, sensitive, easy, and economical method to predict me tastatic recurrence following curative hepatic resection is of clinical urgency. Neovascularization has been shown to be essential for the growth and metastasis of solid tumors. Vascular endothelial growth factor (VEGF), a dimeric hepari n-binding glycoprotein with a molecular weight of about Mr 45000, is one of the most important angiogenic factors. In addition to increasing permeability of blood vessels, VEGF has potent mitogenic effect on vascular endothelial cells[2-9]. Serum VEGF levels have previously been shown to be raised in patients with various tumors, including brain, renal, melanoma, breast, gastrointest inal, and liver malignancies particularly in metastatic diseases[10-15].Because VEGF plays an essential role in tumor angiogenesis and hence the meta stasis and recurrence of HCC, its elevation in serum may be a candid at ebiomarker of metastatic recurrence. Con-sequently, we set out to study whether preoperative serum VEGF could be used as a biomarker of metastatic recurrence following curative hepatic resection in HCC. Since 84.6% of HCC patients have acc ompanied cirrhosis to some extent we also examined serum concentrations of VEGF in cirrhotic patients and normal healthy controls[16]. In addition, we studied the relationship between serum VEGF concentrations and immuno histological expressions of two known metastatic recurrence parameters-p53 and PCNA in tumor tissues.