Korrelation von placental growth factor, vascular endothelial growth factor und soluble vascular endothelial growth factor receptor-1 im Serum mit Tumorstadien und Prognose des hepatozellulären Karzinoms [thesis]

Astrid Wendt, Universitätsbibliothek Der FU Berlin, Universitätsbibliothek Der FU Berlin
The hepatocellular carcinoma is the second most frequent cancer related cause of death worldwide. It is usually a complication of a cirrhosis of the liver or of other risk factors such as a chronical hepatitis B infection or the non-alcoholic fatty liver disease. Being often diagnosed only at a late stage, mortality is very high (15 % 5-year-survival-rate). Besides the common staging systems, no further prognostic or predictive markers for an individually adapted treatment have been
more » ... ve been established. Angiogenic factors are potentially non-invasive markers for (the progression of) HCC and cirrhosis and at the same time possible therapy objectives. The retrospective study at hand investigated a cohort of 263 HCC patients and the influence of clinical and paraclinical parameters on their survival. We determined and compared three factors of angiogenesis (PlGF, VEGF and sVEGFR-1) within the HCC cohort (n=263), a cohort of cirrhosis patients (n=82) and a cohort of healthy probands (n=30). The overall median survival amounted to 33 months. Transplanted patients had the best out-come: more than 60% were still alive after 20 years of observation. End-stage patients had a median survival of 4.5 months. The univariate analysis showed that higher age, alcohol-related liver disease, number and size of lesions, higher tumor stage (with respect to BCLC, CLIP, Okuda and TMN staging systems) as well as higher values of AFP, VEGF and sVEGFR-1 were connected statistically significantly to shorter survival. Patients treated aggressively during intermediary stage survived statistically significantly longer. VEGF had an approximately in-dependent influence on survival. Healthy probands had higher PlGF, VEGF and sVEGFR-1 values than HCC- and cirrhosis patients (mean values in pg/mL: for PLGF: healthy: 9,68/ cirrhosis: 3,48/ HCC: 5,26; for VEGF: healthy: 300,36/ cirrhosis: 241,57/ HCC: 224,37; for sVEGFR-1: healthy: 189,81/ cirrhosis: 60,27/ HCC: 122,32). PlGF values were overall very low. sVEGFR-1 distinguished significantly between HCC an [...]
doi:10.17169/refubium-26977 fatcat:my6lvlz3wzfhjgecvhl3pdhf64