QUANTITATION OF SINUSOID-LIKE VESSELS IN HEPATOCELLULAR-CARCINOMA - ITS CLINICAL AND PROGNOSTIC-SIGNIFICANCE

Angiogenesis is crucial for tumor growth and metastasis. Hepatocellula r carcinoma (HCC) is a typical hypervascular tumor. However, the relat ionship between tumor vascularity and the outcome of patients with HCC has not been evaluated. To clarify whether tumor angiogenesis is rela ted to the prognosis of patients, immunohistochemical staining, using anti-von Willebrand factor (vWF) and anti-CD34, was applied in resecte d specimens from 43 cases of HCC. In nonmalignant tissue, staining was confined to vessels in the portal tract and to a few periportal sinus oids with both of the endothelial markers applied. In tumor tissue, ho wever, sinusoid-like vessels reacted intensively with anti-CD34 but no t with anti-vWF. The intratumor microvessel density (MVD) highlighted by anti-CD34 was 297 +/- 88 (per 0.74 mm(2)), which was significantly higher than that highlighted by anti-vWF (4 +/- 7). When only the MVD highlighted by anti-CDH was analyzed, tumor diameter larger than 2 cm, poor differentiation (Edmondson's II to IV), and portal invasion were significantly related to the subgroup with MVD greater than or equal to 290. Overall survival curves of patients with MVD < 290 were better , and these patients were more likely to remain tumor free, Cox hazard s model revealed intratumor MVD and Edmondson's grade to be independen t prognostic factors for the overall survival of patients. These resul ts demonstrated for the first time that tumor angiogenesis assessed by anti-CD34 was correlated with the outcome of patients with HCC, sugge sting a potential role for anti-CD34 in the diagnosis and treatment of HCC.