Immunohistochemical
Assessment of Angiogenesis in Primary Hepatocellular Carcinoma
Adrian Saftoiu1, Tudorel
Ciurea1, Monica Banita2, Claudia Georgescu3, Violeta Comanescu3,
Ion Rogoveanu1, Florin Gorunescu4, Ion Georgescu5
1) Department of Internal
Medicine, Division of Gastroenterology. 2) Department of Histology.
3) Department of Pathology. 4) Department of Statistics. 5)
Department of Surgery, University of Medicine and Pharmacy Craiova
Abstract
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.
Key words
Hepatocellular carcinoma
- angiogenesis - vascular endothelial growth factor - immunohistochemistry
