Tumor microvessel density as a predictor of recurrence after resection of hepatocellular carcinoma: a prospective study.
OBJECTIVE
This study prospectively evaluated the correlation of tumor microvessel density (MVD) with clinicopathologic features and postoperative recurrence in patients undergoing resection of hepatocellular carcinoma (HCC).


METHODS
Tumor MVD was assessed in 100 patients with resection of HCC using a computer image analyzer after immunostaining for CD34 (MVD-CD34) and von Willebrand factor (MVD-vWF), respectively. Patients were prospectively followed for recurrence.


RESULTS
Mean tumor MVD-CD34 (236/0.74 mm(2)) was higher than mean tumor MVD-vWF (87/0.74 mm(2)) (P <.001). By multiple regression analysis, tumor size was the only pathologic feature significantly related to tumor MVD-CD34. The median MVD-CD34 was 316/0.74 mm(2) in HCCs < or = 5 cm (n = 46) and 146/0.74 mm(2) in HCCs more than 5 cm (n = 54) (P <.001). Among patients with HCCs < or = 5 cm, those with higher than median MVD-CD34 had worse disease-free survival (at 3 years, 13%) than those with a lower MVD-CD34 (at 3 year, 74%) (P =.002). Multivariate analysis showed that tumor MVD-CD34 was the only significant factor predictive of disease-free survival in patients with HCC < or = 5 cm. For HCCs more than 5 cm, MVD-CD34 did not have a significant prognostic influence. MVD-vWF did not have a significant prognostic influence on disease-free survival in either HCCs < or = 5 cm or more than 5 cm.


CONCLUSIONS
This study shows that a high MVD-CD34 was predictive of early postresection recurrence in patients with HCCs < or = 5 cm and, therefore, may be a novel prognostic marker in this subset of patients.
Poon
Ronnie Tung-Ping
RT
Department of Surgery and Pathology, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong, China. poontp@hkucc.hku.hk
Ng
Irene Oi-Lin
IO
Lau
Cecilia
C
Yu
Wun-Ching
WC
Yang
Zhen-Fan
ZF
Fan
Sheung-Tat
ST
Wong
John
J
D018952:Antigens, CD34 / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000276:immunology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000098:blood supply* / Q000276:immunology; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000098:blood supply; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies
D018952:Antigens, CD34; D014408:Biomarkers, Tumor