| Object ive: To determine the absolute and relative valueof microvessel density (MVD), vascular endothelium growth factor (VEGF) protein and its receptors(VEGFR: Flt-1 Flk-1 Flt-4) protein expression in primary tumor and preoperative serum VEGF in predicting recurrence of primaryhepatocellular carcinoma(PHCC). Patients and Methods: We monitored 60patients with PHCC for a median of 30. 5 months. Intratumal MVD was measured after microvessels were immunostained using anti-CD34 antibody. VEGF protein and VEGFR proteins expression were also determined immunohistochemically. Also, We detected preoperative serum VEGF of 30 patients (from the 60 patients) using ELISA(Enzyme-linked immunoadsordent assay). Results were analyzed by t test, Chi-Square test, Bivariate correlation analysis, univariate andmultivariate statistical analysis. Results: MVD, VEGF, Flt-1,Flk-1 andFlt-4 expression and serum VEGF were all positively correlated with tumor diameter, staging, differentiation and cancer embolus(P<0. 05), whereas not correlated with HBV infection and hepatocirrhosis nodules(P>0. 05). MVD, VEGF, Flt-1 and Flk-1 expression and serum VEGF were positively correlated with recurrence(P<0. 05;0.003,0.013,0. 031, 0. 026, respectively). Univariate analysis by Kaplan-Mierer survival analysis showed that MVD, VEGF, Flt-1, Flk-1 and Flt-4 expression and serum VEGF were all significantly predictivt of DPS (disease-free survival) (P<0. 05; 0. 0045, 0.0287, 0.0021, 0093, 0.0472, 0.0201, respectively) . Multivariate analysis showed that MVD, VEGF, Flt-1 and Flk-1 expression and serum VEGF were significant and independent prognostic factors for DPS (P<0.05; 0.009, 0.017, 0.025, 0.042, 0.013,respectively) . Conclusion: MVD, VEGF, Flt-1 and Flk-1 expression andserum VEGF are all independent prognostic indicators for recurrence. Combination of all the six indicators would be more useful in predicting prognosis. Owing to its convenience, serum VEGF may be the most prospective predictor for high-risk recurrence. All these indictors are useful in selection of high-risk recurrence of hepatocellular carcinoma patients who may be eligible to receive more strict re-examinations and appropriately prophylactic therapy, such as anti-angiogenesis therapy . |
