A Preliminary Study Of Vasculogenic Mimicry In Human Hepatocelluar Carcinoma

Objective To preliminarily detect the existence of vasculogenic mimicry in multinodular hepatocellular carcinoma and further to evaluate biological and clinical significance;to discussion the expression of its generation-relate gene.Methods 42 patients with a total of 47 HCC intrahepatic metastasis(IM) nodules who were consequentially hospitalized for radical resection of HCC in the department of hepatobiliary surgery of the first affiliated hospital to Guangxi medical university from February 2008 to September 2008. Histological and immunohistochemical double staining of CD31 and PAS were applied to observe the existence of VM and analyzed the difference among them with regard to their clinicopathologic characteristics. Reverse Transcription PCR(RT-PCR) were applied to study the expression of VE-cadherin, EPHA2 and MMP-2 genes.Results VM exists in human hepatocellular carcinoma: VM could be seen in 16 of the 42(38.1%) cases. The typical forms of VM in the microscope are vessel-like structure which formed by tumor cell, without endothelial cells and the PAS-positive looping pattern. Tumor cells were separated from the tubes by PAS-positive matter like basement membrane. Red blood cell sometimes could be seen in the tubes, which prove VM connect to endothelium-dependent blood vessels, and its connection can be found.Whether the VM is existent in a HCC node had differences in its Edmondson grade, capacity of intrahepatic disseminating and tumor-free survival time(P<0.05). The number of VM is less in well differentiated simples than in poorly differentiated samples. Intrahepatic metastasis happened in VM nodes is much easier than non-VM nodes. The average tumor-free survival time of non-VM cases was longer than that of VM cases.Comparing the difference of VE-cadherin gene, EPHA2 gene and MMP-2 gene expression between VM nodes and non-VM nodes by RT-PCR method demonstrated that VE-cadherin gene, EPHA2 gene and MMP-2 gene have a more intense expression in VM nodes than non-VM nodes(P<0.05). They were significantly correlated with each other in terms of the expression.Conclusion 1. VM has turned out to found also exist in human hepatocellular carcinoma.2. Intrahepatic metastasis happened in VM nodes is much easier than non-VM nodes. VM cases have a higher rate of tumor recurrence, and prognosis is even worse.3. Multiple factors promote the occurrence of VM. VM in HCC involves several signaling molecules that are also involved in embryonic vasculogenesis, including VE-cadherin gene, EPHA2 gene and MMP-2 gene.4. That is no Acknowledged-criterion in VM diagnosis. Combining double staining of CD31 and PAS with routine pathological examination , meanwhile, together detecting VM generation-relate gene such as VE-cadherin, EPHA2 and MMP-2, all are economic and feasible methods.