Evaluation of serum nitric oxide before and after local radiofrequency thermal ablation for hepatocellular carcinoma

Abstract

Background: HCC is one of the leading causes of world wide cancer mortality due to late diagnosis. Chronic hepatitis C virus is one of the main risk factors for the development of Hepatocellular carcinoma (HCC), which is a multi-step process involving different genetic alterations that lead to malignant transformation of hepatocytes. Genetic and molecular abnormalities associated with viral infection or due to inflammatory conditions represent an early step in hepatocarcinogenesis. HCC is a hypervascular solid cancer. Tumor growth depends on angiogenesis, and the ‘‘angiogenic switch’’ of preexisting vessels is required to allow tumor progression, growth, and propagation to supply nutrients and oxygen. Inducible nitric oxide synthase (iNOS) also plays an important role in angiogenesis, regulating several biological processes crucial for tumor growth.

Objectives: Evaluation of serum nitric oxide before and after local  radiofrequency thermal ablation for hepatocellular carcinoma.

Subjects: Twenty patients with proven hepatocellular carcinoma and 15 healthy patients as controls were enrolled in the study.

Methods: History taking, clinical examination, laboratory testing (AlT, AST, Bil γGT, ALP, Albumin, AFP, NO), ultrasound and Spiral CT. Evaluation was done initially and repeated after 2 weeks of tumor ablation by local radiofrequency thermal ablation.

Results: Median of Serum Nitric oxide was statistically significantly higher among HCC patients before radiofrequency thermal ablation (1200 lmol/l) compared to controls (22 lmol/l)where p< 0.001, also the median of NO was statistically significantly declined after radiofrequency thermal ablation compared to before (160, 1200 lmol/l) respectively where p<0.001.

Conclusion: The data suggest that there is an elevation in serum nitric oxide in HCC patients and that is locally produced from the tumor and hence its level significantly drops after local radiofrequency thermal ablation.

Keywords: Nitrous oxide; Hepatocellular carcinoma; Radiofrequency