A Preliminary Study Of Vasculogenic Mimicry In Hepatocelluar Carcinoma And Its Clinical Significance

Objective To detect the existence of vasculogenic mimicry in multinodular hepatocellular carcinoma and further to evaluate biological and clinical significance, to discussion its potential molecular mechanism.Methods 90 specimens obtained from 36 cases of multinodular HCC resection which has been identified their clone origins. Histological and immunohistochemical double staining of CD31 and PAS to observe the existence of VM. Immunohistochemical staining of MMP2, VE-cadherin to explore its potential molecular mechanism.Results VM exists in human multinodular hepatocellular carcinoma. VM was seen in 28 of the 36 (78.7%)cases, and 52 of the 90(57.8%) samples.The typical forms of VM in the microscope are vessel-like structure which formed by tumor cells, without endothelial cells and the PAS-positive looping pattern. Tumor cells were separated from the tubes by PAS-positive matter like basement membrane. Some of the tubes can be filled by PAS-positive matter. Red blood cells could be seen in the tubes, which prove VM connect to endothelium-dependent blood vessels, and its connection can be found.Whether the VM is existent in a node had differences in its Edmondson grade, capacity of intrahepatic disseminating (p<0.05). The number of VM is less in well differentiated simples than in poorly differentiated samples. And Intrahepatic metastasis happened in VM nodes is much easier than non-VM nodes. The average recurrence time and survival time of non-VM cases longer than that of VM cases.The expression of VM generation-related protein.MMP-2 and VE-Cadherin can promote the tumor cells to break through matrix structure and contribute form VM. Comparing the difference of MMP-2 and VE-cadherin expression between VM nodes and non-VM nodes by Mattern scoring method demonstrated that MMP2 and VE-cadherin have a more intense expression in the VM nodes than non-VM nodes (p<0.05).Conclusion 1. VM has a high incidence in multinodular HCC.2. Intrahepatic metastasis happened in VM nodes is much easier than non-VM nodes. VM cases have a higher rate of tumor recurrence, a shorter survival time, and prognosis is even worse.3. VM highly express MMP2 and VE-cadherin in HCC, which play an important role in the process of forming VM.4. Combining double staining of CD31 and PAS with routine pathological examination to detect VM is economic and feasible. Furthermore, it will be advantageous to select the treatment strategies and evaluate prognosis for each patient.