Assessment of the clinical significance of serum vascular endothelial growth factor and matrix metalloproteinase-9 in patients with hepatocellular carcinoma.

The pre-therapeutic serum levels of VEGF and MMP-9 were studied in patients with HCC, cirrhotic patients and in healthy subjects by an ELISA assay to elucidate the relationship between serum VEGF, MMP-9 levels and clinicopathological characteristics of HCC. The serum VEGF and MMP-9 were significantly elevated in HCC patients with macroscopic portal vein invasion and with metastasis as compared to HCC patients with neither invasion nor metastasis. Serum VEGF showed a significant difference between HCC patients with tumor size >5cm and <5 cm, however serum MMP-9 did not vary with tumor size. It was concluded that the portal vein invasion and metastasis in HCC is a complex process involving multiple factors including VEGF-mediated angiogenesis and MMP-9 induced degradation of extracellular matrix. The pre-therapeutic serum VEGF & MMP-9 in HCC might be candidate biomarkers reflecting the disease potential for vascular invasion and metastasis, serum VEGF being a superior biomarker as it correlated also with tumor size.