title: Tumoral and angiogenesis factors in hepatocellular carcinoma after locoregional therapy.
abstract: Locoregional therapy (LRT) is used as a bridge to orthotopic liver transplant (OLT) for hepatocellular carcinoma (HCC) patients. Liver explants in OLT patients with HCC were studied regarding both tumor stage, histology, and immunohistochemical staining for cytokeratin (CK)7, CK19, P53, Ki-67, and vascular endothelial growth factor (VEGF). Patients receiving no LRT (control) (n=30) were compared with LRT treatment groups with conventional transarterial chemoembolization (cTACE) (n=25) or drug-eluting bead transarterial chemoembolization (DEB TACE) (n=17). Tumor stage and histology were similar between treatment and control groups. The mean percent necrosis was significantly higher for treatment groups versus the control group (p<0.0001 for both groups versus control) and was significantly higher in the cTACE group versus the DEB TACE group. Only the DEB TACE group showed peritumoral CK19 positivity, and tumors were all CK19-negative. Using a threshold of 50% of tumoral cells, tumoral VEGF was significantly different between groups, with the control group having the highest degree of positivity; however, peritumoral VEGF was not significantly different between the groups. The Ki-67 proliferation fraction was higher in the treated groups with a statistically significant difference between the DEB-treated group and those without treatment (p=0.02). There were no statistically significant differences in tumoral or peritumoral CK7 or p53. Percent necrosis and percent Ki-67 positivity were higher with LRT, with a significant difference between groups for percent necrosis, confirming that LRT causes necrosis and suggesting that treatment leads to increased proliferation and decreased tumoral VEGF.
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA 30322, USA. abfarri@emory.edu
authors.forename: Alton B
authors.initials: AB
authors.lastname: Farris
authors.forename: Nevra
authors.initials: N
authors.lastname: Dursun
authors.forename: Renumathy
authors.initials: R
authors.lastname: Dhanasekaran
authors.forename: Ipek
authors.initials: I
authors.lastname: Coban
authors.forename: Emily B
authors.initials: EB
authors.lastname: McIntosh
authors.forename: N Volkan
authors.initials: NV
authors.lastname: Adsay
authors.forename: Hyun S
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000473:pathology* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008113:Liver Neoplasms / Q000098:blood supply / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000628:therapy*; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D042461:Vascular Endothelial Growth Factor A