Tumor Grading, Architectural Growth Pattern and Angiogenesis Proprieties Correlation in Surgical Patients Treated for HCC

Background: Tumor grading and architectural growth patterns impact the results, but the unfavorable tumor biology is revealed no sooner than on explant examination. Thus, they are not concerned in preoperative calculations. Aim of study: To evaluate the correlation between circulating EPCS, soluble angiogenesis factors and architectural growth patterns of HCC in surgical patients. Methods: The study reported on 159 patients treated for HCC in 2009/2013; 58 were suitable for surgery, 55 for liver transplantation and 46 for palliation. The rate of circulating EPCs was assessed by the flow cytometer; the serum VEGF concentration was measured by ELISA. The tissue samples were examined for tumor grading and architectural growth patterns of HCC, and for the expression of VGEF/VEGFR-2 by immunohistochemical staining. The data were analyzed statistically. Results: There were 58 trabecular, 43 tubular, and 58 solid tumors of HCC. There were significant differences in the rate of circulating HSCs and EPCs in the blood of their possessors (Chisq=5.8, p<0.05 and Chisq=7.14, p<0.02, respectively). The rate of circulating EPCs correlated with the concentration of VEGFR-2 within the tumor tissue according to the grade of HCC differentiation (r=0.5 p<0.02, r=-0.24, p<0.01, r=-0.5, p<0.004, for Grade I, II, and III, respectively). Conclusion: Angiogenesis capability of the tumor corresponds to its histologic features. The results indicate a benefit from the evaluation of angiogenesis factors in the course of patients’ selection to the treatment options.