Study On Correlation Of VEGFR-2and CD34Expression In Noncancerous Liver Tissue To The Early Recurrence Of The HCV-HCC After Radical Resection

Objective:1. To analyze the recurrence profiles of the hepatitis C virus-related hepatocellularcarcinoma (HCV-HCC) after radical resection,and discuss the risk factors for the earlyand late recurrences.2. To analyze the correlation of VEGFR-2and CD34expression in cirrhosis tissue,noncancerous liver tissue and hepatoma tissue to the clinicopathological features and theearly recurrence of the hepatitis C virus-related hepatocellular carcinoma after radicalresection,and discuss the role of detecting the VEGFR-2and CD34expression innoncancerous liver tissue in predicting the early recurrence and anti-recurrence therapyafter radical resection.Methods:1. The clinicopathologic data of117patients with HCV-HCC who underwentresection surgery were retrospectively reviewed.The recurrence profiles of these patientsafter radical resection were analyzed.Both univariate and multivariate analysis were usedto determined the risk factors for the early and late recurrences.Moreover,the viral factorwas evaluated by stratified analysis.2. To collect38cases of the liver tissue specimen of the hepatitis C virus-relatedhepatocellular carcinoma after radical resection.The immunohistochemical method wasused to detect the VEGFR-2and CD34expression in cirrhosis tissue,noncancerous livertissue and hepatoma tissue;and to analyze the correlation of their expression,clinicopathological features and early postoperative recurrence.Results:1. There were two peaks of recurrence after radical resection of the entire group of HCV-HCC,and the demarcation point between the early and late recurrences was atpostoperative24months.The rate of the early recurrence is higher than the latter.2. Multivariate analysis by COX proportional hazards regression model showed thatthe lower differentiation of tumor cell and microscopic vascular invasion were the riskfactors for the early recurrence (P<0.001),and the viral load was the independent riskfactor for the late recurrence (P=0.008).3. Further stratified analysis indicated that the patients with the sustained negativeviral load had a significantly longer tumor-free survival time than those with sustainedhigh viral load or unstable viral load after surgery(P=0.006),whereas,tumor-free survivaltime between the latter two was no significant difference(P=0.193).4. The VEGFR-2expression between hepatoma tissue and noncancerous liver tissuewas no significant difference（χ2=2.105,P=0.226),whereas,the positive expression ratewas significantly higher than that of cirrhosis tissue（P<0.001).The CD34expression ismainly detected in hepatoma tissue and was significantly different from that of cirrhosistissue and noncancerous liver tissue.5. The correlation analysis indicated that the VEGFR-2expression in noncancerousliver tissue or hepatoma tissue and the CD34expression in noncancerous liver tissuewere related to the early recurrence.COX proportional hazards regression modelindicated that the lower differentiation of tumor cell,the microscopic vascular invasionand the VEGFR-2expression in noncancerous liver tissue were independent risk factorsfor the early recurrence (P<0.001).Conclusion:1. Different risk factors are responsible for early and late recurrence after the radicalresection of the HCV-HCC and the rate of the early recurrence is higher.The lowerdifferentiation of tumor cell,microscopic vascular invasion and the CD34expression innoncancerous liver tissue were independent risk factors for the early recurrence,whereas,the viral load was the independent risk factor for late recurrence.2. The correlation analysis indicated that the VEGFR-2expression in non-cancerousliver tissue and hepatoma tissue were related to the early recurrence,but not warning of the early recurrence in this study.The CD34expression in noncancerous liver tissue wasthe prediction of the early recurrence.The postoperative prophylactic TACE combinedwith Anti-angiogenic treatment may improve the tumor-free survival in early recurrencehigh-risk patients;while postoperative antiviral therapy may improve long-termoutcomes.