Clinical significance of vascular endothelial growth factor in hepatitis C related hepatocellular carcinoma in Egyptian patients

Abstract

Background and aimsSeveral angiogenic factors are involved in the development and progression of hepatocellular carcinoma (HCC), a hypervascular tumor. Vascular endothelial growth factor (VEGF) is a primary driving force for angiogenesis, and its overexpression has been reported in HCC. However, the significance of plasma and tissue VEGF levels in HCC in Egyptian patients with chronic hepatitis C (CHC) infection is understudied. The aim of this study was to evaluate the role of VEGF (measured in plasma and liver tissue) in patients with hepatitis C virus-related HCC and to assess its significance in the diagnosis and prognosis of HCC.Materials and methodsA total of 90 subjects were studied. Among 90 subjects, 60 with CHC were examined and were subdivided into two groups: 30 patients with CHC-related HCC (HCC group) and 30 patients with CHC without HCC (non-HCC group). Thirty apparently healthy subjects served as the control group. VEGF was estimated in plasma by enzyme-linked immunosorbent assay and its expression in liver tissue was evaluated by real-time polymerase chain reaction. VEGF expression level and its relationship to tumor parameters, patients’ liver function profile, and patients’ clinical parameters were also investigated.ResultsPlasma VEGF levels in the HCC group were significantly higher than those of the non-HCC group, and both groups had significantly higher plasma VEGF levels than did the control group. Liver tissue VEGF expression was significantly higher in the HCC group than in the non-HCC group and positively correlated with plasma VEGF in the HCC group. The plasma VEGF levels were positively correlated with patients’ age, aspartate aminotransferase levels, serum alpha-fetoprotein levels, the presence of portal vein thrombosis, and the number of hepatic focal lesions in the HCC group. However, plasma VEGF levels were not significantly correlated with the Child-Pugh score, alanine aminotransferase levels, the size of focal lesions, and Okuda stage. Using both the VEGF and alpha-fetoprotein levels to detect HCC maximizes the sensitivity and specificity.ConclusionPlasma levels of VEGF may be a useful diagnostic and prognostic marker for HCC in patients who have been diagnosed with CHC.

Serum Vascular Endothelial Growth Factor in Patients with Hepatocellular Carcinoma and its Validity as a Tumor Biomarker

“…Li et al, postulated that VEGF can enhance portal vein thrombosis formation in HCC by influencing the angiogenesis process [43]. On the other hand, we did not find a significant correlation between the serum VEGF levels and the number of hepatic focal lesions in contrast to other researchers [24,44] where VEGF accelerates vascular permeability which increases the release of malignant cells into the circulation [45].…”

“…In our study, we found that serum VEGF levels strongly correlated with serum AFP which agrees with other studies [24,46,47], and this supports the prognostic value of both VEGF and AFP in HCC patients [47]. According to the relationship between VEGF and liver function tests, we did not find significant correlations between them in both the HCC group and HCV liver cirrhosis group which agrees with the results obtained by Atta et al [24], where they postulated that VEGF expression cannot be considered as an indicator of the liver synthetic function or the inflammatory state which eliminates the possibility that inflammatory process has an impact on VEGF expression.…”

“…Most studies reported an increased expression of serum VEGF levels in patients with HCC and its reliability for diagnosis of HCC in high-risk patients with liver cirrhosis together with AFP [16,23,24]. The increased expression of VEGF in HCC patients was due to the increased tissue transcript of the VEGF level in the tumor [25], where VEGF enhanced the angiogenesis and increased the vascular endothelial cells, leading to cancer formation [26].…”

P18 peptide, a functional fragment of pigment epithelial-derived factor, inhibits angiogenesis in hepatocellular carcinoma via modulating VEGF/VEGFR2 signalling pathway

“…Hepatocellular carcinoma (HCC) is one of the most common types of carcinoma and is characterized by an enriched blood supply. The progression of angiogenesis is vital for tumour occurrence and development and is closely associated with HCC metastasis, invasion and resistance to therapy ( 5 , 6 ). Thus, several anti-angiogenic drugs (such as sorafenib) have been recommended for clinical applications as treatment options for patients with advanced stage HCC ( 7 , 8 ).…”

Expression of microRNAs-21 and-223 in hepatocellular carcinoma in hepatitis C virus infected Egyptian population

“…Thus, HCV is considered a major public health problem in Egypt. Complications of HCV infection in Egypt are responsible for 67% of morbidity related to liver disease (Atta et al, 2016). Patients with chronic HCV are at risk of developing cirrhosis which may be followed by hepatocellular carcinoma (HCC), .…”