title: Clinical significance of plasma D-dimer levels and serum VEGF levels in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  Angiogenesis and coagulation system activation are associated with tumor growth and metastasis. Vascular endothelial growth factor (VEGF) has been reported to play a major role in tumor angiogenesis. The elevation of plasma D-dimer level indicates the activation of coagulation and fibrinolysis. The purpose of this study was to: (a) evaluate the correlation between serum VEGF and plasma D-dimer level; (b) analyze the clinical features that might affect the VEGF and D-dimer levels in patients with hepatocellular carcinoma.
  
  
  METHODS
  Twenty patients with hepatocellular carcinoma were included prior to treatment. Serum VEGF levels were measured by enzyme-linked immunosorbent assay. Plasma D-dimer levels were measured by quantitative latex microparticle enhanced turbidimetric immunoassay.
  
  
  RESULTS
  The presence of a high plasma D-dimer level was found to be correlated with the presence of central necrosis, higher Child's grade, advanced TNM stage, and the presence of portal vein thrombosis when plasma D-dimer levels were compared between different clinicopathologic groups. Tumors larger than 2 cm in diameter had higher median serum VEGF levels than tumors less than 2cm in diameter. No correlation was found between plasma D-dimer level and serum VEGF level in hepatocellular carcinoma patients (r=0.126, p=0.598).
  
  
  CONCLUSIONS
  No correlation was found between the plasma D-dimer level and the serum VEGF level in hepatocellular carcinoma patients. The plasma D-dimer level appeared to reflect the tumor stage and vascular invasion of hepatocellular carcinoma. Serum VEGF level in hepatocellular carcinoma patients showed a positive correlation with tumor size.
authors.affiliation: Division of Hepatology, Center of Hepato-Gastroenterology Yuan's General Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Chien-Sen
authors.initials: CS
authors.lastname: Tseng
authors.forename: Hoi-Wan
authors.initials: HW
authors.lastname: Lo
authors.forename: Pao-Huei
authors.initials: PH
authors.lastname: Chen
authors.forename: Wan-Long
authors.initials: WL
authors.lastname: Chuang
authors.forename: Chung-Chou
authors.initials: CC
authors.lastname: Juan
authors.forename: Chen-Guo
authors.initials: CG
authors.lastname: Ker
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009367:Neoplasm Staging; D011169:Portal Vein / Q000473:pathology; D011237:Predictive Value of Tests; D012016:Reference Values; D013223:Statistics as Topic; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D005338:Fibrin Fibrinogen Degradation Products; D042461:Vascular Endothelial Growth Factor A; C036309:fibrin fragment D