Liver angiogenesis as a risk factor for hepatocellular carcinoma development in hepatitis C virus cirrhotic patients.
OBJECTIVE
To evaluate the predictive value of hepatocyte proliferation and hepatic angiogenesis for the occurrence of Hepatocellular carcinoma (HCC) in hepatitis C virus (HCV) cirrhotic patients.


METHODS
One hundred-five patients (69 males, 36 females; age range, 51-90 year; median 66 year) with biopsy proven HCV cirrhosis were prospectively monitored for HCC occurrence for a median time of 64 mo. Angiogenesis was assessed by using microvessel density (MVD), hepatocyte turnover by MIB1 and PCNA indexes at inclusion in liver biopsies.


RESULTS
Forty six patients (43.8%) developed HCC after a median time of 55 (6-120) mo while 59 (56.2%) did not. Patients were divided into two groups according to the median value of each index. The difference between patients with low (median MVD = 3; range 0-20) and high (median MVD = 7; range 1-24) MVD was statistically significant (chi(2) = 22.06; P < 0.0001) which was not the case for MIB1 or PCNA (MIB-1: chi(2) = 1.41; P = 0.2351; PCNA: chi(2) = 1.27; P = 0.2589). The median MVD was higher in patients who developed HCC than in those who did not. HCC-free interval was significantly longer in patients with the MVD < or = 4 (P = 0.0006). No relationship was found between MIB1 or PCNA and MVD (MIB-1 r(2) = 0.00007116, P = 0.9281; PCNA: r(2) = 0.001950; P = 0.6692). MVD only was able to predict the occurrence of HCC in these patients. Among other known risk factors for HCC, only male sex was statistically associated with an increased risk.


CONCLUSIONS
Liver angiogenesis has a role for in HCV-related liver carcinogenesis and for defining patients at higher risk.
Mazzanti
Roberto
R
Department of Internal Medicine, University of Florence School of Medicine, Viale GB Morgagni 85, I-50134 Firenze, Italy. r.mazzanti@dmi.unifi.it
Messerini
Luca
L
Comin
Camilla E
CE
Fedeli
Lorenzo
L
Ganne-Carrie
Nathalie
N
Beaugrand
Michel
M
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000209:etiology* / Q000473:pathology; D049109:Cell Proliferation; D005260:Female; D016174:Hepacivirus; D006526:Hepatitis C / Q000150:complications* / Q000473:pathology; D022781:Hepatocytes / Q000473:pathology; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000150:complications* / Q000209:etiology / Q000473:pathology; D008113:Liver Neoplasms / Q000098:blood supply / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000150:complications* / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors