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

Abstract

Background: Hepatocellular Carcinoma (HCC) is one of the most common cancers associated with deaths worldwide and the presence of valid biomarkers for early diagnosis in high-risk patients can ameliorate the outcome of HCC. Vascular Endothelial Growth Factor (VEGF) has been found to play an essential role in the process of HCC growth and progression. Objectives: Therefore, we evaluated the serum VEGF levels in patients with HCC and liver cirrhosis and estimated its significant value for differentiating HCC patients from liver cirrhosis patients. Material and methods: Eighty-one subjects were enrolled in the study, 30 patients had HCC, 31 patients had liver cirrhosis and 20 were healthy control subjects. VEGF and AFP were measured using ELIZA. Abdominal ultrasound and triphasic abdominal computed tomography were performed in all subjects. Receiver Operating Characteristics curve analysis was performed for serum VEGF to determine its validity as a tumor biomarker. Results: The median levels of the serum VEGF were highly expressed in the HCC group (418 pg/ml) and the liver cirrhosis group (308 pg/ml) with no significant difference (P = 0.767); however both groups showed a significant increase compared to the control group (0.8 pg/ml, P <0.000). Serum VEGF showed high sensitivity (100%) and high specificity (100%) in differentiating HCC patients from controls with a cut-off value of ≥ 64.2 pg/ml, although it showed low sensitivity (29.2%) and specificity (85.7%) for differentiating HCC patients from liver cirrhosis patients. Conclusion: VEGF can be used as a reliable biomarker for differentiating HCC patients from healthy subjects but it can't be used as a reliable biomarker for differentiating HCC patients from high-risk patients as liver cirrhosis. The elevated serum VEGF levels in HCC and liver cirrhosis patients can elucidate the crucial role of angiogenesis in HCC and liver cirrhosis.

Serum Angiopoietin 2 acts as a diagnostic and prognostic biomarker in hepatocellular carcinoma

“…Immunohistochemical (IHC) studies have shown that VEGF expression is not confined to the tumor area but also in surrounding non-tumor areas in a similar manner 26 , 27 . Concordant with these findings, there was no significant difference in the median serum VEGF levels between HCC patients and cirrhotic patients without HCC 28 . In contrast, Ang2 has been observed to be more highly expressed in tumor tissues than in surrounding non-tumor tissues and to be less expressed in the normal liver 29 .…”