title: Serum angiopoietin-2 level as a predictor of tumor invasiveness in patients with hepatocellular carcinoma.
abstract: BACKGROUND
  Because hepatocellular carcinoma (HCC) has important angiogenic activity, the expression of angiopoietin-2 (Ang-2) may have a pathogenic role. The information about the influence of serum Ang-2 (sAng-2) in patients with HCC is scarce.
  
  
  OBJECTIVE
  The aim was to assess the association between sAng-2 levels and characteristics of tumor and liver disease in patients with HCC.
  
  
  METHODS
  sAng-2 concentrations in peripheral (sAng-2-P) and hepatic (sAng-2-H) veins were analyzed by ELISA in 33 patients with chronic liver disease who underwent a splanchnic hemodynamic study. Thirty-two patients received treatment for HCC.
  
  
  RESULTS
  The median age was 61 years and 79% were male. Hepatitis C infection (70%) was the main etiology. Most patients were Child-Pugh grade A (72.7%). sAng-2-P and sAng-2-H were well correlated (r = 0.95; p < 0.0001). A significant association was found between sAng-2-H and lobar tumor extension, vascular thrombosis, BCLC staging, infiltrating pattern, abnormal alpha-fetoprotein level, fulfillment of the Milan criteria, and performance of nonsystemic treatment. sAng-2-H also showed a significant correlation with the MELD score (r = 0.49; p = 0.007), albumin (r = -0.63; p < 0.001), and HVPG (r = 0.44; p = 0.02). Eleven patients received treatment with radiofrequency ablation and eight with transarterial chemoembolization. HCC treatment did not influence the sAng-2 concentration while the necrosis response to treatment was not influenced by previous sAng-2 levels.
  
  
  CONCLUSIONS
  Ang-2 seems to play an important role in the angiogenic processes of HCC and its serum levels are associated with tumor characteristics and invasive behavior. Our results suggest that Ang-2 is not related with treatment response and its level is not modified by treatment.
authors.affiliation: Gastroenterology Unit, Hospital Universitario del Sureste, Arganda del Rey, Madrid, Spain. antoniodisan@yahoo.es
authors.forename: Antonio
authors.initials: A
authors.lastname: Diaz-Sanchez
authors.forename: Ana
authors.initials: A
authors.lastname: Matilla
authors.forename: Oscar
authors.initials: O
authors.lastname: Nuñez
authors.forename: Raquel
authors.initials: R
authors.lastname: Lorente
authors.forename: Alejandro
authors.initials: A
authors.lastname: Fernandez
authors.forename: Diego
authors.initials: D
authors.lastname: Rincón
authors.forename: Rocio
authors.initials: R
authors.lastname: Campos
authors.forename: Rafael
authors.initials: R
authors.lastname: Bañares
authors.forename: Gerardo
authors.initials: G
authors.lastname: Clemente
mesh_terms: D000368:Aged; D042702:Angiopoietin-2 / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D058625:End Stage Liver Disease / Q000097:blood; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011446:Prospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D042702:Angiopoietin-2; D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins