Significance of Serum Vascular Endothelial Growth Factor in Chronic Liver Disease and Hepatocellular Carcinoma: An Exploratory Study

Background and Objectives: Vascular endothelial growth factor (VEGF) is the most potent directly acting angiogenic growth factor that plays an important role in inducing tumor-associated angiogenesis. We evaluated the clinical significance of the circulating VEGF in patients with hepatocelluar carcinoma (HCC) and chronic liver disease (CLD). Patients and Methods: The study included 65 patients [20 with chronic viral hepatitis (CVH), 20 with liver cirrhosis (LC) and 25 with HCC] and 15 age- and gender- matched healthy subjects as controls. For each studied subject, detection of hepatitis viral markers, and assessment of liver function tests, α-fetoprotein (AFP) and VEGF were performed. Results: There was a significantly higher VEGF level in the sera of HCC patients as compared to other groups (p< 0.001). Serum VEGF level was significantly associated with portal vein tumor thrombosis (p< 0.01), but was not related to tumor size. There was no significant difference between the serum VEGF levels in either LC or CVH groups when compared to the controls. Moreover, no significant difference was detected between the different Child-Pugh classes among LC patients. Furthermore, no correlation was found between the level of serum VEGF and AFP, serum albumin, aminotransferases or prothrombin time (PT) in all the studied groups. Conclusions: Serum VEGF may be useful as a tumor marker for diagnosis of HCC and as a prognostic marker for tumor invasion. Large studies with greater numbers of patients and controls is required to support our conclusion. Key words: Chronic liver disease, hepatocellular carcinoma (HCC), tumor marker, vascular endothelial growth factor (VEGF) Abbreviations: AFP: α-fetoprotein, CLD: chronic liver disease, CVH: chronic viral hepatitis, ECM: extracellular matrix, HCC: hepatocelluar carcinoma, LC:  liver cirrhosis, PT: prothrombin time, VEGF: vascular endothelial growth factor