Objective: to evaluate the prognostic role of serum VEGF and angiostatin levels in patients with HCC.
Patients and methods: Between April 2010 and April 2012, 40 patients diagnosed with HCC, presented to the
Departments of Gastroenterology and clinical oncology, Assiut Univ. Hospital were recruited in this study. The
control group consisted of 40 healthy individuals and another group of 40 cirrhotic patients with no evidence of HCC
attending the Gastroenterology clinic of our hospital were included. Serum samples were prospectively collected
from all groups for estimation of α-FP, VEGF, and angiostatin levels using ELISA technique. Patients with HCC
were managed according to the BCLC strategy. All patients were reviewed in the Gastroenterology and oncology
clinics at least every 1 to 2 months. Results: The mean serum VEGF concentrations (632.3±5.1 pg/mL) were
significantly higher in patients with HCC than in liver cirrhosis patients and healthy controls (mean
value148.0±23.32 pg/mL, and 45.0±6.4 pg/mL, respectively) (P < 0.05). In addition, HCC patients showed increased
serum VEGF concentrations with increased BCLC score (Odd’s Ratio1.05 - 95% confidence interval 1.11–3.9). On
multivariate analysis, serum VEGF level was an independent prognostic factor (hazard ratio 1.86 (95 per cent
confidence interval 1.10 to 3.92); P = 0.032). We also found that angiostatin levels were significantly lower in HCC
patients compared with patients with liver cirrhosis and control subjects (P <0.05). Furthermore, there was no
significant correlation between serum angiostatin levels and VEGF levels. We did not find any correlation between
angiostatin serum levels and overall survival. Conclusion: this study demonstrated that serum VEGF level is a
prognostic marker for HCC that can help guidance in clinical decision-making regarding therapy and outcome. Our
study also showed that angiostatin is potential diagnostic marker that may aid in early detection of HCC. However,
further studies should be performed.