간세포암 환자에서 혈관 내피세포 성장 인자, 형질전환 성장 인자 - β1 및 염기성 섬유아세포 성장 인자 발현의 임상적 의의

Abstract

PURPOSE: Angiogensis plays an important role in the proliferation and metastasis of solid tumors. Hepatocellular carcinoma (HCC) is the second most prevalent tumor in Korean males and is known to be a typical hypervascular tumor with frequent invasion of the portal vein. This study was designed to evaluate the expression of VEGF, TGF-beta1, b-FGF in HCC and to determine whether these angiogenic growth factors are related to clinicopathologic factors as well as prognosis. METHODS: The medical records of 30 patients who were diagnosed as HCC and treated with hepatic resection between January 1994 and December 1998 at Soonchunhyang University Chunan Hospital were selected according to the condition of the paraffin block fixation. The prognostic factors such as age, sex, tumor size, concentration of serum alpha-fetoprotein, presence of liver cirrhosis, presence of tumor emboli in the portal vein, TMN stage, amount of transfusion during the operation, hepatitis B virus (HBV) infection, and Edmonson-Steiner (E-S) grade were investigated. The immunopathologic expression of TGF-beta1, b-FGF, and VEGF was examined and compared with survival using Kaplan-Meier estimate and cox propositional hazard model. RESULTS: Thirty patients (24 males, 6 females) were included in the study, with mean age of 50.6 years. The mean size of the tumor was 5.2 cm. All patients were followed up for7 to 63 months. Child's classification A and B were 23 (76.7%) and 7 (23.3%) cases, respectively. The immunopathologic expression of VEGF, b-FGF, and TGF-beta1 were 56.7%, 33.3%, and 33.3%, respectively. VEGF was significantly related to tumor size and TNM classification (P<0.05). alpha-fetoprotien, Child's and TNM classification, E-S grade, and portal vein invasion were significant risks for survival. However, no angiogenic factors were related to the hazard function of survival. In a Cox proportional model, patients with at least one expression of these factors showed a 1.15 hazard risk (P>0.05). alpha-fetoprotien (risk=6.33), Child classification (risk=7.65), and E-S grade (risk=1.94) remained as significant independent prognostic factors of survival (P<0.05). CONCLUSION: Our data suggests that the expression of angiogenic factors in HCC cells may be a potential prognostic factor for survival and is associated with the clinicopathologic factors of HCC.