title: Immunohistochemical assessment of angiogenesis in primary hepatocellular carcinoma.
abstract: BACKGROUND
  Primary hepatocellular carcinoma (HCC) is characterized by the presence of angiogenesis, which is necessary for tumor growth, progression and distant metastasis. Vascular endothelial growth factor (VEGF) is clearly expressed in HCC, in variable degrees as a function of differentiation and vascularisation.
  
  
  OBJECTIVE
  To assess angiogenesis in HCC, by means of immunohistochemical analysis of the expressions of VEGF.
  
  
  METHODS
  Immunohistochemical techniques were performed on the samples obtained by ultrasound-guided liver biopsies or intraoperative biopsies, in 32 patients with HCC.
  
  
  RESULTS
  Positive expression of VEGF was always observed in the extracellular matrix of portal tracts of the non-neoplastic or tumor areas (extra- and intranodular areas of HCC patients). VEGF was not expressed inside the hepatocytes of extranodular non-neoplastic areas of the patients with HCC. However, we did find positive reactions for VEGF inside the tumor hepatocytes in 34.38 % of the HCC patients. The difference between VEGF expression for the patients with poor and undifferentiated HCC as compared with moderate and well-differentiated HCC was statistically significant (P < 0.05).
  
  
  CONCLUSIONS
  Our study demonstrated an increased VEGF expression in tumor hepatocytes, which progressed with the dedifferentiation of HCC. VEGF expression was always present in the extracellular matrix, supporting the hypothesis of paracrine activation of VEGF at the level of tumor stroma. Consequently, increased VEGF expression might be responsible for the activation of angiogenesis in HCC.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, University of Medicine and Pharmacy, Str. Horia no.11, Craiova, Romania. adry@umfcv.ro
authors.forename: Adrian
authors.initials: A
authors.lastname: Săftoiu
authors.forename: Tudorel
authors.initials: T
authors.lastname: Ciurea
authors.forename: Monica
authors.initials: M
authors.lastname: Baniţă
authors.forename: Claudia
authors.initials: C
authors.lastname: Georgescu
authors.forename: Violeta
authors.initials: V
authors.lastname: Comănescu
authors.forename: Ion
authors.initials: I
authors.lastname: Rogoveanu
authors.forename: Florin
authors.initials: F
authors.lastname: Gorunescu
authors.forename: Ion
authors.initials: I
authors.lastname: Georgescu
mesh_terms: D000328:Adult; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000276:immunology*; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis / Q000096:biosynthesis*
chemical_list: D042461:Vascular Endothelial Growth Factor A