Study of angiogenic factors: Vascular endothelia growth factor (VEGF) and basic fibroblast growth factor (bFGF) in hepatocellular carcinoma

Abstract

Hepatocellular carcinoma (HCC) is one of the most commonmalignancies in the world. Hepatocellular carcinoma is characterized by high vascularity, so tumor angiogenesis nowadays has been considered to be a strong prognostic factor in patients with HCC .The pre-therapeutic serum vascular endothelial growth factor(VEGF) and basic fibroblast growth factor (bFGF) levels in the HCC patients appear to reflect the disease's potential activity of vascular invasion and metastasis. The pre-therapeutic serum levels of the angiogenic factors VEGF and bFGF were detected in the sera of HCC patients to find new markers to be used for diagnosis of HCC, and were compared with the routinely used tumor markers used for diagnosis of HCC as AFP, CEA, and CA19.9. The relation between the serum levels of VEGF, and bFGF and the clinical characteristics of HCC was also elucidated.On comparing the studied tumor markers among the three studied groups, all the tumor markers were highest in the HCC group, followed the benign liver diseases, and lastly the normal control group (p-value= <0.001 each). On comparing the studied tumor markers according to different prognostic factors, only AFP showed statistically significant result with the tumor size (p-value=0.048). CEA, CA19-9 and bFGF were statistically significantly higher in cases with ascites than in those without ascites (p-value= 0.03, 0.02, and 0.003 respectively). Both VEGF and bFGF were higher in patient with metastasis than those without metastasis but only bFGF was statistically significant (p-value = 0.001). AFP, CA19.9, and bFGF were statistically significantly higher in cases with edema than in those without edema (p-value= 0.03, 0.05, and 0.05 respectively). Only AFP showed statistically significantly result with portal vein thrombosis (p-value= 0.03) and stage of the disease (p-value= 0.002). On measuring the sensitivity and specificity of the different tumor markers in HCC, VEGF showed the highest sensitivity (98%), while AFP showed the highest specificity (100%). The best diagnostic accuracy for the either abnormal double combinations was observed with AFP & VEGF. The best diagnostic accuracy for the both abnormal double combinations was observed with VEGF/PLT ratio & VEGF. The best all abnormal triple combination was detected between the combination VEGF, bFGF and VEGF/PLT ratio with diagnostic accuracy of 81.1%.

Keywords: Hepatocellular carcinoma, vascular endothelial growth factor, basic fibroblast growth factor, angiogenesis.

Egyptian Journal of Biochemistry and Molecular Biology Vol. 24 (2) 2006: pp. 130-153