RESUMO
BACKGROUND: Vascular endothelial growth factor (VEGF165) is stored, transported and released by platelets. Platelet functional abnormalities have been described in patients with hepatocellular carcinoma (HCC). Thus, this study was designed to investigate the behavior of VEGF165 with respect to platelet activation in HCC. METHODS: Plasma and serum VEGF165 and plasma sP-selectin levels were analyzed in patients with HCC (n=70) or cirrhosis (n=45) and control subjects (n=70). Given the thrombocytopenia that characterizes both HCC and cirrhotic patients, plasma VEGF165 and sP-selectin as well as serum VEGF (plt-VEGF165-load) levels were normalized by platelet counts. RESULTS: Median concentrations of plasma VEGF165/platelet (p=0.002) and sP-selectin/platelet (p<0.0001) were higher in HCC or cirrhotic patients compared to controls. Moreover, sP-selectin/platelet was the only independent variable predictive of plasma VEGF165/platelet at multivariate analysis (p<0.0001). Conversely, plt-VEGF165-load correlated with tumor diameter (p<0.05) but not with sP-selectin/platelet and was an independent predictor for 5year overall survival (p=0.012). CONCLUSIONS: The results obtained are suggestive for VEGF165 release by tumor in HCC. It is plt-VEGF165-load, but not plasma VEGF165 or serum VEGF165 that is an independent predictor for overall survival of HCC patients.