Is the vascular endothelial growth factor messenger RNA expression in resectable hepatocellular carcinoma of prognostic value after resection?

Aim: To study whether vascular endothelial growth factor messenger RNA (VEGF mRNA) in the hepatocellular carcinoma (HCC) tissues obtained after curative resection has a prognostic value. Methods: Using a reverse-transcription polymerase chain reaction (RT-PCR)-based assay, VEGF mRNA was determined prospectively in liver tissues of 50 controls and in HCC tissues of 50 consecutive patients undergoing curative resection for HCC. Results: Among the isoforms of VEGF mRNA, VEGF₁₆₅ and VEGF₁₂₁ were expressed. By multivariate analysis, a higher level of VEGF₁₆₅ in HCC tissue correlated with a significant risk of HCC recurrence (P=0.038) and significantly with recurrence-related mortality (P=0.045); while VEGF₁₂₁ did not. Other significant predictors of HCC recurrence included cellular dedifferentiation (P=0.033), an absent or incomplete capsule (P=0.020), vascular permeation (P=0.018), and daughter nodules (P=0.006). The other significant variables of recurrence related mortality consisted of vascular permeation (P=0.045), and cellular dedifferentiation (P=0.053). The level of VEGF mRNA in HCC tissues, however, did not significantly correlate with tumor size, cellular differentiation, capsule, daughter nodules, vascular permeation, necrosis and hemorrhage of tumors. Conclusion: The expression of VEGF mRNA, especially isoform VEGF₁₆₅, in HCC tissues, may play a significant and independant role in the prediction of postoperative recurrence of HCC.